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Boura D, Spanakis M, Markakis G, Notas G, Lionis C, Tzanakis N, Paraskakis E. Exploring the Relationship between Wind Patterns and Hospital Admissions Due to Respiratory Symptoms in Children. CHILDREN (BASEL, SWITZERLAND) 2024; 11:717. [PMID: 38929296 PMCID: PMC11201383 DOI: 10.3390/children11060717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/31/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Respiratory disorders significantly impact adolescents' health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory health, particularly in regions characterized by distinct annual wind patterns. Crete is situated in the central-eastern Mediterranean Sea and frequently faces southerly winds carrying Sahara Desert sand from Africa and northerly winds from the Aegean Sea. This retrospective study analyzes long-term wind direction data and their relationship to respiratory symptoms observed in children up to 14 years old admitted at the University Hospital of Heraklion between 2002 and 2010. Symptoms such as headache, dyspnea, dry cough, dizziness, tachypnea, throat ache, and earache were predominantly reported during the presence of southern winds. Fever, productive cough, and chest pain were more frequently reported during northern winds. Cough was the most common symptom regardless of the wind pattern. Southern winds were significantly associated with higher probabilities of productive or non-productive cough, headache, dyspnea, tachypnea, dizziness, earache, and throat ache. Northern winds were related to a higher incidence of productive cough. Rhinitis, asthma, allergies, pharyngitis, and sinusitis were related to southern winds, while bronchiolitis and pneumonia were associated with northern winds. These findings underscore the critical role of local climatic factors, emphasizing their potential impact on exacerbating respiratory conditions in children. Moreover, they point out the need for further research to elucidate the underlying mechanisms and develop targeted interventions for at-risk populations.
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Affiliation(s)
- Despoina Boura
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Marios Spanakis
- Department of Forensic Sciences and Toxicology, School of Medicine, University of Crete, 71003 Heraklion, Greece;
- Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research & Technology–Hellas, 71110 Heraklion, Greece
| | - George Markakis
- Department of Social Work, Faculty of Health Sciences, Hellenic Mediterranean University, 71004 Heraklion, Greece;
| | - George Notas
- Department of Emergency Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Christos Lionis
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Greece;
| | - Nikolaos Tzanakis
- Department of Respiratory Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece; (D.B.); (N.T.)
| | - Emmanouil Paraskakis
- Paediatric Respiratory Unit, Paediatric Department, University of Crete, 71500 Heraklion, Greece
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Chavoshian S, Cao X, Thommandram A, Stanbrook MB, Tarlo SM, Fossat Y, Yadollahi A. Designing and validating an experimental protocol to induce airway narrowing in older adults with and without asthma. Biomed Eng Online 2024; 23:28. [PMID: 38448963 PMCID: PMC10916193 DOI: 10.1186/s12938-023-01197-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/20/2023] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Persons with asthma may experience excessive airway narrowing due to exercise or exposure to cold air, worsening their daily functionality. Exercise has several benefits for asthma control, but it may induce airway narrowing in some persons with asthma. When combined with cold temperatures, it introduces another layer of challenges. Therefore, managing this interaction is crucial to increase the quality of life in individuals with asthma. The purpose of this study was to develop a reliable experimental protocol to assess the effects of exercise and cold air on airway narrowing in adults with asthma in a controlled and safe environment. METHODS This study was a randomized cross-over study in adults with and without asthma. Participants underwent a protocol involving a 10-min seated rest, followed by a 10-min cycling on a stationary bike in different temperatures of 0, 10, or 20 ∘ C. The sequence of room temperatures was randomized, and there was a 30-min interval for recovery between each temperature transition. In each temperature, to measure lung function and respiratory symptoms, oscillometry and a questionnaire were used at 0 min (baseline), after 10 min of sitting and before starting biking (pre-exercise), and after 10 min of biking (post-exercise). At each room temperature, the changes in airway mechanics and asthma symptoms among baseline, pre-exercise, and post-exercise were compared with one-way repeated measures ANOVA or Friedman Rank Test. Within each arm, cardiac and thoraco-abdominal motion respiration signals were also measured continuously using electrodes and calibrated respiratory inductance plethysmographs, respectively. RESULTS A total of 23 persons with asthma (11 females, age: 56.3 ± 10.9 years, BMI: 27.4 ± 5.7 kg/m2) and 6 healthy subjects (3 females, age: 61.8 ± 9.1 years, BMI: 28.5 ± 3.1 kg/m2) were enrolled in the study. Cold temperature of 0∘ C induced airway narrowing in those with and without asthma after 10 and 20 min, respectively. Exercise intervention had significant changes in airway narrowing in participants with asthma in the range of 10-20∘ C. Our results showed that in asthma, changes in subjective respiratory symptoms were due to both cold temperatures of 0 and 10∘ C and exercise in the 0-20∘ C range. Respiratory symptoms were not noticed among the healthy participants. CONCLUSION In conclusion, our findings suggest that exposure to cold temperatures of 0∘ C could serve as a reliable method in the experimental protocol for inducing airway narrowing in asthma. The impact of exercise on airway narrowing was more variable among participants. Understanding these triggers in the experimental protocol is essential for the successful management of asthma in future studies.
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Affiliation(s)
- Shaghayegh Chavoshian
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
| | - Xiaoshu Cao
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
| | - Anirudh Thommandram
- Labs Department, Klick Health, Klick Inc, 175 Bloor St. East, Toronto, M4W 3R8, ON, Canada
| | - Matthew B Stanbrook
- Department of Medicine, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
- Department of Medicine, University Health Network Toronto Western Hospital, 399 Bathurst St., Toronto, M5T 2S8, ON, Canada
| | - Susan M Tarlo
- Department of Medicine, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada
- Department of Medicine, University Health Network Toronto Western Hospital, 399 Bathurst St., Toronto, M5T 2S8, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St., Toronto, M5T 1P8, ON, Canada
| | - Yan Fossat
- Labs Department, Klick Health, Klick Inc, 175 Bloor St. East, Toronto, M4W 3R8, ON, Canada
| | - Azadeh Yadollahi
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave, Toronto, M5G 2A2, ON, Canada.
- Institute of Biomedical Engineering, University of Toronto, 164 College St., Toronto, M5S 3G9, ON, Canada.
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Cheng CG, Yen SY, Hsiao CC, Lin YY, Chang YH, Chen YH, Cheng CA. Short-Term Exposure Effect of Ambient Fine Particulate Matter, Ozone and Cold Temperature on Emergency Room Visits for Asthma Patients. TOXICS 2023; 11:94. [PMID: 36850970 PMCID: PMC9964231 DOI: 10.3390/toxics11020094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The acute effects of ozone, cold temperature and particulate matter less than 2.5 μm (PM2.5) in size related to asthma attacks are well known worldwide. The adverse effects of ozone and cold temperature on asthma morbidity in Taiwan are still inconclusive. (2) Methods: This retrospective study included patients who had asthma emergency room visits (ERVs) from 1 January 2016 to 31 December 2019 in a regional hospital in Taiwan. The short-term negative effects were estimated using Distributed Lag Non-Linear Models (DLNMs) for the relative risks (RRs) of asthma ERVs associated with PM2.5, ozone and cold temperature exposures within 5 days. (3) Results: There was a significant association between a 10 ppm increase in PM2.5 exposure and asthma ERVs at a 2-day lag (RR 1.166, 95% confidence interval (C.I.): 1.051-1.294). There was a significant association between ozone and asthma ERVs at a 1-day lag (RR 1.179, 95% C.I.: 1.034-1.345). The ambient temperature in cold weather compared with the temperature of minimum asthma ERV showed an RR of 1.214, 95% C.I.: 1.009-1.252 at a 1-day lag. (4) Conclusions: This study provides evidence that short-term exposure to fine suspended particulates, ozone and inverse temperature is associated with asthma exacerbation.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Shang-Yih Yen
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chih-Chun Hsiao
- Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan
| | - Yu-Hsuan Chen
- Division of Chest Medicine, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei 11220, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Chen Z, Fu Q, Wu L, Xu P, Xu D, Pan X, Lou X, Wang X, Yao K, Mo Z. Quantifying the associations of the air pollutant SO 2 on outpatient visits for conjunctivitis in Hangzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:13246-13255. [PMID: 36125687 DOI: 10.1007/s11356-022-23073-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
The aim of this study is to further investigate the single and cumulative associations of SO2 on outpatient visits for conjunctivitis. Data from outpatient visits, air pollutants, and meteorology was collected by the Eye Center of the Second Affiliated Hospital of the Zhejiang University School of Medicine, the Environmental Protection Department of Zhejiang Province, and the Meteorological Administration of Zhejiang Province from July 1, 2014, to November 30, 2019. A Poisson generalized linear regression model (PGLM), combined with a distributed lag nonlinear model (DLNM), was employed to analyze the association between SO2 and outpatient visits for conjunctivitis using PM2.5 and NO2 as covariates. Of the 539,649 outpatients for conjunctivitis recruited for analysis, 58.1% were female. Obvious single associations of SO2 were observed in outpatient visits for conjunctivitis, which is consistent with our previous results using a time-stratified case crossover design. A delay in the associations of SO2 on outpatient visits for conjunctivitis was further confirmed, with the longest lag being 12 days. The strongest lag effect was found at lag 0-11 with RR95th vs 25th = 1.30 (1.24, 1.37), and RR90h vs 25th = 1.23 (1.18, 1.28). Furthermore, the results showed that old people may be more sensitive to the associations of SO2 than adults and the younger ones. Our study provides the first evidence that outpatient visits for conjunctivitis are positively associated with both single and cumulative air pollutant SO2 exposure, suggesting that people especially elders had better to decrease outdoor activities when the SO2 concentration is above safe level.
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Affiliation(s)
- Zhijian Chen
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Qiuli Fu
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Lab of Ophthalmology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Lizhi Wu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Peiwei Xu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Dandan Xu
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xuejiao Pan
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xiaoming Lou
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Xiaofeng Wang
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China
| | - Ke Yao
- Eye Center of the 2nd Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Lab of Ophthalmology, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Zhe Mo
- Department of Environmental and Occupational Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, 310051, Zhejiang Province, China.
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Lu C, Zhang Y, Li B, Zhao Z, Huang C, Zhang X, Qian H, Wang J, Liu W, Sun Y, Norbäck D, Deng Q. Interaction effect of prenatal and postnatal exposure to ambient air pollution and temperature on childhood asthma. ENVIRONMENT INTERNATIONAL 2022; 167:107456. [PMID: 35952466 DOI: 10.1016/j.envint.2022.107456] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/28/2022] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although mounting evidence has associated air pollution and environmental temperature with children's health problems, it is unclear whether there is an interaction between these factors on childhood asthma. OBJECTIVES To explore the effects of temperature-pollution interactions during pre- and post-natal periods on asthma among pre-schoolers. METHODS A retrospective cohort study of 39,782 pre-schoolers was performed during 2010-2012, in seven cities in China. Exposure to three temperature indicators (TI) and three critical ambient air pollutants, including particulate matter with aerodynamic diameter ≤ 10 μm (PM10), sulfur dioxide (SO2) and nitrogen dioxide (NO2) as proxies of industrial and vehicular air pollution, was estimated by an inverse distance weighted (IDW) method. Two-level logistical regression analysis was used to examine the association between both pre- and post-natal exposure and childhood asthma in terms of odds ratio (OR) and 95 % confidence interval (CI). RESULTS Asthma prevalence in pre-schoolers at age of 3-6 years (6.9 %) was significantly associated with traffic-related air pollutant (NO2) exposure, with ORs (95 % CI) of 1.17 (1.06, 1.28), 1.19 (1.05-1.34) and 1.16 (1.03-1.31) for an IQR increase in NO2 exposure during lifetime, pregnancy, and entire postnatal period respectively. Furthermore, childhood asthma was positively associated with exposure to increased temperature during lifetime, pregnancy, and entire postnatal period with ORs (95 % CI) = 1.89 (1.66, 2.16), 1.47 (1.34, 1.61), and 1.15 (1.11, 1.18) respectively, while was negatively associated with decreased temperatures. Childhood asthma was positively related with exposure to extreme heat days (EHD) during postnatal period particularly in first year of life respectively with ORs (95 % CI) = 1.23 (1.04, 1.46) and 1.26 (1.07, 1.47), but was not related with extreme cold days (ECD) exposure. A combination of high air pollutant levels and high temperatures significantly increased the risk of asthma during both pre- and post-natal periods. Strikingly, we found a significantly positive interaction of temperature and PM10 or SO2 on asthma risk among boys and younger children. CONCLUSIONS Prenatal and postnatal exposure to ambient air pollution and high temperatures are independently and jointly associated with asthma risk in early childhood.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University, Changsha, Hunan, China
| | - Yinping Zhang
- School of Architecture, Tsinghua University, Beijing, China
| | - Baizhan Li
- Key Laboratory of Three Gorges Reservoir Region's Eco-Environment, Chongqing University, Chongqing, China
| | - Zhuohui Zhao
- Department of Environmental Health, Fudan University, Shanghai, China
| | - Chen Huang
- School of Environment and Architecture, University of Shanghai for Science and Technology, Shanghai, China
| | - Xin Zhang
- Institute of Environmental Science, Shanxi University, Taiyuan, China
| | - Hua Qian
- School of Energy & Environment, Southeast University, Nanjing, China
| | - Juan Wang
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Wei Liu
- Institute for Health and Environment, Chongqing University of Science and Technology, Chongqing, China
| | - Yuexia Sun
- School of Environmental Science and Engineering, Tianjin University, Tianjin, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Qihong Deng
- School of Public Health, Zhengzhou University, Zhengzhou, Henan, China.
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Zhu Y, Yang T, Huang S, Li H, Lei J, Xue X, Gao Y, Jiang Y, Liu C, Kan H, Chen R. Cold temperature and sudden temperature drop as novel risk factors of asthma exacerbation: a longitudinal study in 18 Chinese cities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 814:151959. [PMID: 34843761 DOI: 10.1016/j.scitotenv.2021.151959] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/31/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Few studies have explored the role of ambient temperature in asthma exacerbation. OBJECTIVE We aimed to explore the association of temperature with diurnal peak expiratory flow (PEF) variation and asthma exacerbation. METHOD We developed a longitudinal study among asthmatic adults in 18 Chinese cities. Subjects recorded PEF in dynamic pulmonary function monitoring from 2017 to 2020. Linear mixed-effect model and generalized additive model with distributed non-linear models were used to assess the effect of temperature and temperature change between neighboring days (TCN) on diurnal PEF variation and the risk of asthma exacerbation. RESULT We evaluated a total of 79,217 daily PEF monitoring records from 4467 adult asthmatic patients. There were significant increase of diurnal PEF variation and higher risk of asthma exacerbation with cold and sudden temperature drop. Compared with the referent temperature (99th percentile, 32 °C), exposure to moderate cold (25th percentile, 3 °C) and extreme cold (2.5th percentile, -7 °C) was associated with elevations of 1.28% and 1.16% in diurnal PEF variation over lag 0-2 days, respectively. The odds ratios of asthma exacerbation (determined by diurnal PEF variation >20%) at the two temperature cutoffs were 1.68 and 1.73. A sudden temperature drop (2.5th percentile of TCN, -5 °C) was associated with 1.13% elevation in diurnal PEF variation, and with increased risk of asthma exacerbation (odd ratio = 1.50) over lag 0-4 days. CONCLUSION This large multicenter study provided the first-hand empirical evidence that cold temperature and a temperature drop may increase the risk of asthma exacerbation.
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Affiliation(s)
- Yixiang Zhu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine and National Center for Respiratory Medicine & National Clinical Research Center for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China
| | - Suijie Huang
- Guangzhou Homesun Medical Technology Co.,Ltd, Guangdong Province, China
| | - Huichu Li
- Department of Environmental Health, Harvard T.H.Chan School of Public Health, Boston, MA, USA
| | - Jian Lei
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xiaowei Xue
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Ya Gao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Yixuan Jiang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, NHC Key Lab of Health Technology Assessment, Fudan University, Shanghai, China; IRDR ICoE on Risk Interconnectivity and Governance on Weather/Climate Extremes Impact and Public Health, Fudan University, Shanghai, China; Shanghai Typhoon Institute/CMA, Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China.
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Chen Y, Kong D, Fu J, Zhang Y, Zhao Y, Liu Y, Chang Z, Liu Y, Liu X, Xu K, Jiang C, Fan Z. Associations between ambient temperature and adult asthma hospitalizations in Beijing, China: a time-stratified case-crossover study. Respir Res 2022; 23:38. [PMID: 35189885 PMCID: PMC8862352 DOI: 10.1186/s12931-022-01960-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background Studies on the associations between ambient temperature and asthma hospitalizations are limited, and the results are controversial. We aimed to assess the short-term effects of ambient temperature on the risk of asthma hospitalizations and quantify the hospitalization burdens of asthma attributable to non-optimal temperature in adults in Beijing, China. Methods We collected daily asthma hospitalizations, meteorological factors and air quality data in Beijing from 2012 to 2015. We applied a time-stratified case-crossover design and fitted a distributed lag non-linear model with a conditional quasi-Poisson regression to explore the association between ambient temperature and adult asthma hospitalizations. The effect modifications of these associations by gender and age were assessed by stratified analyses. We also computed the attributable fractions and numbers with 95% empirical confidence intervals (eCI) of asthma hospitalizations due to extreme and moderate temperatures. Results From 2012 to 2015, we identified a total of 18,500 hospitalizations for asthma among adult residents in Beijing, China. Compared with the optimal temperature (22 °C), the cumulative relative risk (CRR) over lag 0–30 days was 2.32 with a 95% confidence interval (CI) of 1.57–3.42 for extreme cold corresponding to the 2.5th percentile (− 6.5 °C) of temperature distribution and 2.04 (95% CI 1.52–2.74) for extreme heat corresponding to the 97.5th percentile (29 °C) of temperature distribution. 29.1% (95% eCI 17.5–38.0%) of adult asthma hospitalizations was attributable to non-optimum temperatures. Moderate cold temperatures yielded most of the burdens, with an attributable fraction of 20.3% (95% eCI 9.1–28.7%). The temperature-related risks of asthma hospitalizations were more prominent in females and younger people (19–64 years old). Conclusions There was a U-shaped association between ambient temperature and the risk of adult asthma hospitalizations in Beijing, China. Females and younger patients were more vulnerable to the effects of non-optimum temperatures. Most of the burden was attributable to moderate cold. Our findings may uncover the potential impact of climate changes on asthma exacerbations. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01960-8.
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Affiliation(s)
- Yuxiong Chen
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Dehui Kong
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Jia Fu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yongqiao Zhang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yakun Zhao
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yanbo Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Zhen'ge Chang
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Yijie Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Xiaole Liu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Kaifeng Xu
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China
| | - Chengyu Jiang
- Department of Biochemistry, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100005, China
| | - Zhongjie Fan
- Department of Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, No.1 Shuaifuyuan Wangfujing Dongcheng District,, Beijing, 100730, China.
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Huang J, Yang X, Fan F, Hu Y, Wang X, Zhu S, Ren G, Wang G. Outdoor air pollution and the risk of asthma exacerbations in single lag0 and lag1 exposure patterns: a systematic review and meta-analysis. J Asthma 2021; 59:2322-2339. [PMID: 34809505 DOI: 10.1080/02770903.2021.2008429] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objective: To synthesize evidence regarding the relationship between outdoor air pollution and risk of asthma exacerbations in single lag0 and lag1 exposure patterns.Methods: We performed a systematic literature search using PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials, China National Knowledge Internet, Chinese BioMedical, and Wanfang databases. Articles published until August 1, 2020 and the reference lists of the relevant articles were reviewed. Two authors independently evaluated the eligible articles and performed structured extraction of the relevant information. Pooled relative risks (RRs) and 95% confidence intervals (CIs) of lag0 and lag1 exposure patterns were estimated using random-effect models.Results: Eighty-four studies met the eligibility criteria and provided sufficient information for meta-analysis. Outdoor air pollutants were associated with increased risk of asthma exacerbations in both single lag0 and lag1 exposure patterns [lag0: RR (95% CI) (pollutants), 1.057(1.011, 1.103) (air quality index, AQI), 1.007 (1.005, 1.010) (particulate matter of diameter ≤ 2.5 μm, PM2.5), 1.009 (1.005, 1.012) (particulate matter of diameter, PM10), 1.010 (1.006, 1.014) (NO2), 1.030 (1.011, 1.048) (CO), 1.005 (1.002, 1.009) (O3); lag1:1.064(1.022, 1.106) (AQI), 1.005 (1.002, 1.008) (PM2.5), 1.007 (1.004, 1.011) (PM10), 1.008 (1.004, 1.012) (NO2), 1.025 (1.007, 1.042) (CO), 1.010 (1.006, 1.013) (O3)], except SO2 [lag0: RR (95% CI), 1.004 (1.000, 1.007); lag1: RR (95% CI), 1.003 (0.999, 1.006)]. Subgroup analyses revealed stronger effects in children and asthma exacerbations associated with other events (including symptoms, lung function changes, and medication use).Conclusion: Outdoor air pollution increases the asthma exacerbation risk in single lag0 and lag1 exposure patterns.Trial registration: PROSPERO, CRD42020204097. https://www.crd.york.ac.uk/.Supplemental data for this article is available online at https://doi.org/10.1080/02770903.2021.2008429 .
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Affiliation(s)
- Junjun Huang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xiaoyu Yang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Fangfang Fan
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Yan Hu
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Xi Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Sainan Zhu
- Department of Biostatistics, Peking University First Hospital, Beijing, China
| | - Guanhua Ren
- Department of Library, Peking University First Hospital, Beijing, China
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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9
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Yamaguchi H, Nozu K, Ishiko S, Kondo A, Ninchoji T, Nagano C, Takeda H, Unzaki A, Ishibashi K, Morioka I, Nagase H, Iijima K, Ishida A. Impact of the State of Emergency during the COVID-19 Pandemic in 2020 on Asthma Exacerbations among Children in Kobe City, Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111407. [PMID: 34769923 PMCID: PMC8583023 DOI: 10.3390/ijerph182111407] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/23/2021] [Accepted: 10/26/2021] [Indexed: 12/21/2022]
Abstract
The coronavirus disease (COVID-19) pandemic altered environmental factors. We studied the impact of these changes on asthma exacerbation (AE) by comparing the AE-related environmental factors between COVID-19 (2020) and pre-COVID-19 (2011–2019) eras. Between 2011 and 2020, 278,465 children (<16 years old) visited our emergency department, and 7476 were diagnosed with AE. The number of patients showed spring and fall peaks in 2011–2019. Multivariate analyses showed significant positive relationships of the number of AE patients with the average temperature among all patients and 0–5-year-olds and with sulfur dioxide (SO2) levels in 2011–2019 among 0–5-year-olds. Although the spring peak in the number of patients was not observed in 2020 after declaration of a state of emergency, the fall peak was again observed after the state of emergency was lifted. No changes in average temperature were detected, but SO2 was significantly reduced following declaration of the state of emergency in 2020. Therefore, SO2 reduction might have contributed to the disappearance of the peak of AE. However, a fall peak was observed again in 2020, although SO2 levels continued to be low. These data suggest that person to person interaction seems to be associated with AE, presumably due to unknown viral infections.
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Affiliation(s)
- Hiroshi Yamaguchi
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
- Correspondence: ; Tel.: +81-78-382-5111; Fax: +81-78-382-5050
| | - Kandai Nozu
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Shinya Ishiko
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Atsushi Kondo
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Takeshi Ninchoji
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - China Nagano
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Hiroki Takeda
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Ai Unzaki
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
| | - Kazuto Ishibashi
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1, Oyaguchi, Kami-cho, Itabashi-ku 173-8610, Japan;
| | - Hiroaki Nagase
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Kazumoto Iijima
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan; (K.N.); (S.I.); (A.K.); (T.N.); (C.N.); (H.T.); (H.N.); (K.I.)
| | - Akihito Ishida
- Kobe Children’s Primary Emergency Medical Center, 1-4-1 Wakihamakaigandori, Chuo-ku, Kobe 651-0073, Japan; (A.U.); (K.I.); (A.I.)
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10
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Grjibovski AM, Adilbekova B, Omralina E, Imangazinova S, Akhmetova Z, Ainabai A, Kalmakhanov S, Aituganova A, Kosbayeva A, Menne B, Odland JØ. Effects of air temperature on the number of ambulance calls for asthma during cold season in Nur-Sultan- the second coldest capital in the world. Int J Circumpolar Health 2021; 80:1978228. [PMID: 34547983 PMCID: PMC8462835 DOI: 10.1080/22423982.2021.1978228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Deleterious effect of cold on overall mortality is well-established. We studied associations between the air temperature and the number f ambulance calls for asthma in Nur-Sultan, Kazakhstan – the second coldest capital in the world. Daily counts of ambulance calls for asthma in Nur-Sultan for the cold seasons (October-March) 2006–2010 were obtained from the Municipal Ambulance Station. Associations between the number of calls and mean and minimum apparent temperatures (average for lags 0–15) were studied using first-order Poisson auto-regression models controlling for wind speed and effects of month, year, weekends and holidays. Altogether, there were 7373 ambulance calls for asthma during the study period. An inverse association between minimum apparent temperature and the number of calls was observed for the age-group 60 years and older. A decrease of the minimum apparent temperature by 1°C was associated with an increase in the number of calls by 1.7% (95% CI: 0.1%-3.3%) across the whole temperature spectrum. No associations in other age groups were found. Our results suggest an inverse association between the average 15-day lag minimum apparent temperature and the number of ambulance calls during the cold season in Nur-Sultan, but this is limited to the oldest age-group.
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Affiliation(s)
- Andrej M Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia.,Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.,West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.,Department of Public Health and Health Policy, Al Farabi Kazakh National University, Almaty, Kazakhstan
| | - Bibigul Adilbekova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Elvira Omralina
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Saule Imangazinova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Zhanar Akhmetova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Ayagul Ainabai
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Sundetgali Kalmakhanov
- Department of Public Health and Health Policy, Al Farabi Kazakh National University, Almaty, Kazakhstan
| | - Aliya Aituganova
- Department of Internal Medicine, Medical University Astana, Nur-Sultan, Kazakhstan
| | - Aliya Kosbayeva
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Bettina Menne
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Øyvind Odland
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
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11
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Kabir AF, Ng CFS, Yasumoto S, Hayashi T, Watanabe C. Effect of Ambient Temperature on Daily Nebulized Asthma Hospital Visits in a Tropical City of Dhaka, Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18030890. [PMID: 33498592 PMCID: PMC7908622 DOI: 10.3390/ijerph18030890] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 01/14/2021] [Accepted: 01/19/2021] [Indexed: 11/19/2022]
Abstract
The acute effect of temperature on asthma morbidity in Bangladesh is not well understood. As climate varies extensively in different parts of the world, the relation between temperature and asthma might also differ. We investigated the association between temperature and asthma-related hospital visits in the tropical city of Dhaka. We analyzed information from a total of 5989 asthma patients who received ambulatory care in the form of nebulized medication at the National Asthma Center in Mohakhali, Dhaka from February to November 2013. A time-stratified case-crossover study was conducted to estimate the effect of daily temperature, with consideration of delayed effects and possible confounders such as relative humidity and political strikes. An inverse association was observed between temperature and the number of hospital visits. The effect was delayed for approximately a week. A degree centigrade decrease in mean temperature (averaged across lags 0-6) was associated with an increase of approximately 4.5% (95% CI 1.5, 7.5) in all asthma visits. The association was evident in adult males but marginal in elderly males. A positive association (lag 0) was observed among adult females, whereas no association was observed among children. Strikes significantly modified the effect among the elderly. Findings suggest temperature declines affect asthma outcomes in a warm climate, and this effect can be delayed and vary by sex and age group.
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Affiliation(s)
- Ayesha Ferdosi Kabir
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan
- Correspondence:
| | - Shinya Yasumoto
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
| | - Taiichi Hayashi
- Center for Southeast Asian Studies, Kyoto University, Kyoto 606-8501, Japan;
| | - Chiho Watanabe
- Department of Human Ecology, School of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan; (A.F.K.); (S.Y.); (C.W.)
- National Institute for Environmental Studies, Tsukuba, Ibaraki 305-0053, Japan
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12
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Maheswari S, Pethannan R, Sabarimurugan S. Air pollution enhances susceptibility to novel coronavirus (COVID-19) infection - an impact study. Environ Anal Health Toxicol 2020; 35:e2020020-0. [PMID: 33434420 PMCID: PMC7829407 DOI: 10.5620/eaht.2020020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/22/2020] [Indexed: 01/22/2023] Open
Abstract
On concurring to the current evidence, the myriad of vulnerable COVID-19 (Coronavirus Disease 19) transmission is acquiring through human-to-human transmission through droplets, which is depicting devastating pandemic. Urbanization and industrialization are the major contributing factors to the on-going change in global climate, with increased air pollution and poor air quality. As the global climate and air quality deteriorate, air pollutants remain as a fundamental concern to public health. Air pollution has been globally acknowledged as a major influence and exacerbating factor for human morbidity and mortality influenced on various respiratory diseases such as lung cancer, bronchitis, chronic obstructive pulmonary diseases, pneumonia, asthma, and influenza. Patients by long - term exposure to polluted air leads to chronic lung and heart conditions are less able to fight off lung infections and likely to die. Polluted air in developed countries is causing heart and lung damage and is responsible for early deaths in a year. This is also likely the case for COVID-19. The more severe impact by COVID-19 on city dwellers and those exposed to toxic fumes leads to the primary health damage such as respiratory infections than on others. The health damage inflicted on people by long-standing air pollution in cities is likely to increase the death rate by COVID-19. By lowering air pollution levels probability to reduce the spread of most vulnerable viruses by aerosol to fight against any possible future pandemics.
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Affiliation(s)
- S. Maheswari
- Department of Microbiology, Centre for Research & PG Studies, Indian Academy Degree College - Autonomous, Bangalore, India
| | - Rajarajan Pethannan
- Department of Microbiology, Centre for Research & PG Studies, Indian Academy Degree College - Autonomous, Bangalore, India
| | - Shanthi Sabarimurugan
- Theranostics, GenesisCare, WA, Australia
- School of Biomedical Sciences, Faculty of Health and Medical Sciences, The University of Western Australia Perth, WA, Australia
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13
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Lu C, Norbäck D, Li Y, Deng Q. Early-life exposure to air pollution and childhood allergic diseases: an update on the link and its implications. Expert Rev Clin Immunol 2020; 16:813-827. [PMID: 32741235 DOI: 10.1080/1744666x.2020.1804868] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Although mounting evidence has linked environmental factors with childhood allergies, some specific key issues still remain unclear: what is the main environmental factor? what is the critical timing window? And whether these contribute to the development of disease? AREAS COVERED This selective review summarizes recent epidemiological studies on the association between early-life exposure to indoor/outdoor air pollution and childhood allergic diseases. A literature search was conducted in the PubMed and Web of Science for peer-reviewed articles published until April 2020. Exposure to the traffic-related air pollutant, NO2, exposure during pregnancy and early postnatal periods is found to be associated with childhood allergies, and exposure during different trimesters causes different allergic diseases. However, exposure to classical air pollutants (PM10 and SO2) also contributes to childhood allergy in developing countries. In addition, early-life exposure to indoor renovation and mold/dampness significantly increases the risk of allergy in children. A synergistic effect between indoor and outdoor air pollution is found in the development of allergic diseases. EXPERT OPINION Early-life exposure to outdoor air pollution and indoor environmental factors plays an important role in the development of childhood allergic diseases, and the synergy between indoor and outdoor exposures increases allergy risk. The available findings support the hypothesis of the 'fetal origins of childhood allergy,' with new implications for the effective control and early prevention of childhood allergies.
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Affiliation(s)
- Chan Lu
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University , Uppsala, Sweden
| | - Yuguo Li
- Department of Mechanical Engineering, The University of Hong Kong , Hong Kong, China
| | - Qihong Deng
- XiangYa School of Public Health, Central South University , Changsha, China.,Hunan Engineering Research Center of Early Life Development and Disease Prevention, XiangYa Hospital, Central South University , Changsha, China.,School of Energy Science and Engineering, Central South University , Changsha, China
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14
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Chen TT, Zhan ZY, Yu YM, Xu LJ, Guan Y, Ou CQ. Effects of hourly levels of ambient air pollution on ambulance emergency call-outs in Shenzhen, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:24880-24888. [PMID: 32337675 DOI: 10.1007/s11356-020-08416-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/12/2020] [Indexed: 06/11/2023]
Abstract
Some researches have shown the associations between air pollution and hospital-based emergency department visits, while the evidence about the acute effects of air pollution on emergency ambulance dispatches for the whole population is rarely available, especially on an hourly time scale. This paper aimed to investigate the effects of hourly concentrations of ambient air pollution on hourly number of ambulance emergency call-outs (AECOs) in Shenzhen, China. AECO data were collected from Shenzhen Emergency Center from January 2013 to December 2016. A time-stratified case-crossover design with conditional Poisson regression was performed to fit the relationship between hourly air pollution and AECOs. The distributed lag model was applied to determine lag structure of the effects of air pollutants. There were a total of 502,862 AECOs during the study period. The significant detrimental effects of SO2, PM2.5, and PM10 appeared immediately with a following harvesting effect after 5 h and the effects lasted for about 96 h. The cumulative effect estimates of four pollutants over 0-96 h were 13.99% (95% CI 7.52-20.85%), 2.07% (95% CI 0.72-3.43%), 1.20% (95% CI 0.54-1.87%), and 2.46% (95% CI 1.63-3.29%), respectively. We did not observe significant effects of O3. This population-based study quantifies the adverse effects of air pollution on ambulance dispatches and provides evidence of the lag structure of the effects on an hourly time scale.
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Affiliation(s)
- Ting-Ting Chen
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Zhi-Ying Zhan
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Yi-Min Yu
- Shenzhen Center for Prehospital Care, Shenzhen, China
- The People's Hospital of Longhua, Shenzhen, China
| | - Li-Jun Xu
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Ying Guan
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China
| | - Chun-Quan Ou
- Department of Biostatistics, State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
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Yu HR, Lin CHR, Tsai JH, Hsieh YT, Tsai TA, Tsai CK, Lee YC, Liu TY, Tsai CM, Chen CC, Chang CH, Hsu TY, Niu CK. A Multifactorial Evaluation of the Effects of Air Pollution and Meteorological Factors on Asthma Exacerbation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114010. [PMID: 32512940 PMCID: PMC7313451 DOI: 10.3390/ijerph17114010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/14/2020] [Accepted: 06/02/2020] [Indexed: 01/05/2023]
Abstract
In the real world, dynamic changes in air pollutants and meteorological factors coexist simultaneously. Studies identifying the effects of individual pollutants on acute exacerbation (AE) of asthma may overlook the health effects of the overall combination. A comprehensive study examining the influence of air pollution and meteorological factors is required. Asthma AE data from emergency room visits were collected from the Taiwan National Health Insurance Research Database. Complete monitoring data for air pollutants (SO2; NO2; O3; CO; PM2.5; PM10) and meteorological factors were collected from the Environmental Protection Agency monitoring stations. A bi-directional case-crossover analysis was used to investigate the effects of air pollution and meteorological factors on asthma AE. Among age group divisions, a 1 °C temperature increase was a protective factor for asthma ER visits with OR = 0.981 (95% CI, 0.971–0.991) and 0.985 (95% CI, 0.975–0.994) for pediatric and adult patients, respectively. Children, especially younger females, are more susceptible to asthma AE due to the effects of outdoor air pollution than adults. Meteorological factors are important modulators for asthma AE in both asthmatic children and adults. When studying the effects of air pollution on asthma AE, meteorological factors should be considered.
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Affiliation(s)
- Hong-Ren Yu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Kaohsiung 83301, Taiwan
| | - Chun-Hung Richard Lin
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
- Correspondence: ; Tel.: +886-7-5252000 (ext. 4339); Fax: +886-7-5254-301
| | - Jui-Hsiu Tsai
- Department of Psychiatry, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chia-Yi 62247, Taiwan;
- PhD Program in Environmental and Occupation Medicine, (Taiwan) National Health Research Institutes and Kaohsiung Medical University, Kaohsiung 80737, Taiwan
| | - Yun-Ting Hsieh
- Department of Computer Science and Engineering, National Sun Yat-sen University, Kaohsiung 80424, Taiwan;
| | - Ti-An Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chang-Ku Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Yi-Chen Lee
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Ta-Yu Liu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Min Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Cheng Chen
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
| | - Chih-Hao Chang
- Department of Respiratory Therapy, Chang Gung Memorial Hospital–Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Te-Yao Hsu
- Department of Obstetrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan;
| | - Chen-Kuang Niu
- Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung 83301, Taiwan; (H.-R.Y.); (T.-A.T.); (C.-K.T.); (Y.-C.L.); (T.-Y.L.); (C.-M.T.); (C.-C.C.); (C.-K.N.)
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Veremchuk LV, Mineeva EE, Vitkina TI, Grigorieva EA, Gvozdenko TA, Golokhvast KS. The response ranges of pulmonary function and the impact criteria of weather and industrial influence on patients with asthma living in Vladivostok. JOURNAL OF ENVIRONMENTAL HEALTH SCIENCE & ENGINEERING 2020; 18:235-242. [PMID: 32399235 PMCID: PMC7203380 DOI: 10.1007/s40201-020-00458-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 02/10/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE To determine the response of pulmonary function (PF) to the influence of environmental factors in patients with different levels of asthma control. MATERIALS AND METHODS Patients with controlled (136 people) and uncontrolled (96 people) asthma living in the conditions of monsoon climate and technogenic pollution in Vladivostok were examined. Discriminant analysis that provides the basis for dividing initial data into classes, as according to standards and expert estimates, was used to calculate ranges of PF response in asthma patients. The selection of discriminant functions with the highest values of constant and coefficient made it possible to identify the optimal quantitative ranges. RESULTS Analysis of the discriminant value of Wilks' lambda (α) has shown that the intensity of PF response to climatic and technogenic factors varies depending on level of disease control (controlled asthma - α = 0.67-0.79, uncontrolled asthma - α =0.05-0.44). The criteria and ranges of PF response also differ depending on level of disease control. In controlled asthma, PF response reflects an adaptive-compensatory dependence. The reaction to the environmental factors is rather weak; therefore, it could be detected by only more sensitive examination method (body plethysmography). In uncontrolled asthma, the response to the influence of environment quality is active and could be clearly identified by spirography. CONCLUSIONS The climatic and technogenic environment of Vladivostok causes strong pathogenic impact on patients with uncontrolled asthma. The effects of dust fraction 0-1 μm, deeply penetrating into respiratory organs, and day-to-day variability of wind speed, which induces weather sensitivity, are particularly adverse.
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Affiliation(s)
- Lyudmila V. Veremchuk
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena E. Mineeva
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Tatyana I. Vitkina
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Elena A. Grigorieva
- Institute for Complex Analysis of Regional Problems Far Eastern Branch of Russian Academy of Sciences, Birobidzhan, Russian Federation
| | - Tatyana A. Gvozdenko
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
| | - Kirill S. Golokhvast
- Vladivostok Branch of Federal State Budgetary Science Institution, Far Eastern Scientific Center of Physiology and Pathology of Respiration, Institute of Medical Climatology and Rehabilitative Treatment, Vladivostok, Russian Federation
- Far Eastern Federal University, Vladivostok, Russian Federation
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Zhang W, Xiang Y, Lu C, Ou C, Deng Q. Numerical modeling of particle deposition in the conducting airways of asthmatic children. Med Eng Phys 2019; 76:40-46. [PMID: 31879223 DOI: 10.1016/j.medengphy.2019.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 09/30/2019] [Accepted: 10/20/2019] [Indexed: 02/05/2023]
Abstract
Mounting evidence has linked long- and short-term exposure to particulate air pollution with the incidence and exacerbation of asthma in children, but the biological pathogenesis is unclear. We examined the deposition of particles in the airways of asthmatic children. A planar and symmetric model of airways for 4-year-old asthmatic children was considered. Airflow and particle deposition in the upper (G3-G6) and lower (G9-G12) conducting airways were numerically investigated using computation fluid dynamics (CFD) method. We considered the manifestation of moderate (30% reduction in airway diameter) and severe (60% reduction) asthma. Micron particles (1-10 µm) were considered. We found that particle deposition in the asthmatic children was significantly higher than that in healthy children. The deposition efficiency increased slowly with particle size for healthy children, but increased rapidly for asthmatic children, such that smaller particles could be deposited in the conducting airways of asthmatics. For healthy children, particles were deposited by inertial impaction and gravitational sedimentation respectively in the upper and lower airways, but deposited by inertial impaction in asthmatic children. The severity of the asthma increased the particle deposition in the airways. Our study indicated that asthmatic children were more susceptible to the effect of particulate air pollution. The constricted airways increased the particle deposition by inertial impaction, which may be the biological pathogenesis that causes the hospitalization of asthma in children. Avoiding exposure during air pollution events will be an effective measure to reduce the asthma attack.
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Affiliation(s)
- Wenwen Zhang
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Yuguang Xiang
- School of Energy Science and Engineering, Central South University, Changsha 410083, China
| | - Chan Lu
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; XiangYa School of Public Health, Central South University, Changsha 410078, China
| | - Cuiyun Ou
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; School of Atmospheric Sciences, Sun Yat-Sen University, Guangzhou 510275, China
| | - Qihong Deng
- School of Energy Science and Engineering, Central South University, Changsha 410083, China; XiangYa School of Public Health, Central South University, Changsha 410078, China; School of Public Health, Zhengzhou University, Zhengzhou 450001, China; School of School of Architecture and Art, Central South University, Changsha 410083, China.
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18
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Effects of Meteorological Factors on Hospitalizations in Adult Patients with Asthma: A Systematic Review. Can Respir J 2019; 2019:3435103. [PMID: 31281551 PMCID: PMC6589223 DOI: 10.1155/2019/3435103] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/05/2019] [Accepted: 05/05/2019] [Indexed: 01/14/2023] Open
Abstract
Background Environmental factors such as weather variables contribute to asthma exacerbation. The impact of meteorological factors on asthma-related hospital admissions (HAs) or emergency department visits (EDVs) has been assessed in the literature. We conducted a systematic review to establish a conclusion of whether these findings from the literature are consistent and generalizable or if they vary significantly by certain subgroups. Objective This study aims to review the effect of meteorological variables on asthma HAs and EDVs in adults, to identify knowledge gaps and to highlight future research priorities. Method A systematic search was conducted in electronic databases such as PubMed, Embase, and CINAHL. All studies published in English were screened and included if they met the eligibility criteria. Two independent reviewers assessed the quality of the studies and extracted the data. The available evidence was summarized and presented using a harvest plot. Results Our initial search returned a total of 3887 articles. After screening titles, abstracts, and full texts, 16 studies were included. Thirty-one percent of the included studies (5/16) found that temperature was the only factor associated with asthma hospitalization or EDVs. Six studies (37%) found that both temperature and relative humidity were associated with HAs. Four studies (25%) identified thunderstorms as a possible factor associated with asthma hospitalization in adults. Conclusion Our review suggests that HAs and EDVs due to asthma are associated with many meteorological factors. Among the articles included in this review, changing temperature is the most commonly studied variable. We did not find studies that measured barometric pressure, weather phenomena, or the effect of tornados. To develop effective strategies to protect subjects at risk, further studies are required.
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Lam HCY, Hajat S, Chan EYY, Goggins WB. Different sensitivities to ambient temperature between first- and re-admission childhood asthma cases in Hong Kong - A time series study. ENVIRONMENTAL RESEARCH 2019; 170:487-492. [PMID: 30641275 DOI: 10.1016/j.envres.2018.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 11/07/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVES Asthma can be triggered by various factors due to different etiologies. Environmental factors remain a common trigger of asthma, especially amongst children, and such ambient exposures can be harder to avoid compared to behavioral triggers. As such, the contribution of environmental factors may be enhanced when considering repeat asthma cases compared to initial presentations. To test this hypothesis, we assessed associations between ambient temperature and hospital admissions for asthma in Hong Kong and stratified admission records into first and repeat asthma hospitalizations. METHODS The daily number of asthma hospitalizations among children aged 0-5 years in Hong Kong during 2007-2011 was regressed on daily mean temperature using distributed lagged nonlinear models, with adjustment for seasonal patterns, day-of-week effects, and other meteorological factors and air-pollutants. Analyses were stratified by summer/winter and by type of admission (first admission and repeated admission). RESULTS About 33% of the 12284 asthma hospitalizations were repeat admissions. Repeat admissions demonstrated higher sensitivity to high temperature in the summer. During this period, high temperatures were associated with increased risk of repeat admission but not with first admissions: RR (95% CI) comparing 31 °C vs. 29 °C across lags 0-15 days was 3.40 (1.26, 9.18) and 0.74 (0.31, 1.77) for repeat and first admissions respectively. In the cold season, all admissions increased with falls in temperature, with slightly stronger associations apparent for repeat admissions compared to first admission: 1.20 (1.00, 1.44) vs. 1.10 (0.96, 1.26) respectively comparing risk at 15 °C vs. 12 °C across lags 0-5 days. CONCLUSIONS To our knowledge, this is the first study to show stronger associations between ambient temperature and repeat asthma admissions compared to first admissions. The higher sensitivity among those experiencing repeat admissions may allow for more personalized disease management. Given the substantial differences in associations by admission type, future studies of ambient exposures on asthma should consider analyzing the two groups separately.
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Affiliation(s)
- Holly Ching Yu Lam
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, University of London, United Kingdom
| | - Emily Ying Yang Chan
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - William Bernard Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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Chan CL, Phan DV, Yang NP, Pan RH, Wu CY, Chen CL, Kuo CY. A survey of ambulatory-treated asthma and correlation with weather and air pollution conditions within Taiwan during 2001-2010. J Asthma 2018; 56:799-807. [PMID: 30012027 DOI: 10.1080/02770903.2018.1497649] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: This study of asthma was performed to evaluate annual trends in emergency department (ED) for 10 years. Weather and air pollution factors affecting asthma were also studied in order to identify the important factors and alert the public in advance. Methods: A survey of ambulatory-treated asthma patients was performed and the correlations with weather and air pollution factors examined in a cohort of one million patients in 2010. The fixed-cohort study analyzed trends, medical costs, and annual prevalence grouped by age and gender. Results: The number of asthma patients visiting EDs and non-emergency (non-ED) clinics significantly increased, with average annual percentage changes (AAPCs) of 2.3 and 4.6%, respectively. The average direct medical cost for EDs was increased significantly as compared with that of non-ED visits. Classification of asthma visits by hospital level indicated that local hospitals and others exhibited a significantly increasing trend (AAPC =15.3% [95% CI: 14.3-16.2]). The annual prevalence of asthma in males, females, and children was significantly increased (AAPCs of 1.5, 1.8, and 3.9%, respectively). Asthma patient hospitalizations were significantly correlated with temperature, humidity, and air pollution factors. Conclusions: The number of non-ED visits due to asthma increased, and the average direct medical cost for ED admissions also increased. Asthma patients tended to visit local hospitals primarily. Asthma visits by children increased, but a decrease was observed in adults. The number of hospitalized asthma patients was negatively correlated with temperature and humidity but positively correlated with the levels of PM2.5, PM10, and NO2.
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Affiliation(s)
- Chien-Lung Chan
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,b Innovation Center for Big Data and Digital Convergence, Yuan Ze University , Taoyuan , Taiwan, Republic of China
| | - Dinh-Van Phan
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,b Innovation Center for Big Data and Digital Convergence, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,c Faculty of Statistics - Informatics, University of Economics, The University of Danang , Da Nang , Vietnam
| | - Nan-Ping Yang
- d Department of Surgery & Orthopedics, Keelung Hospital, Ministry of Health & Welfare , Keelung , Taiwan, Republic of China.,e Faculty of Medicine, School of Medicine, National Yang-Ming University , Taipei , Taiwan, Republic of China
| | - Ren-Hao Pan
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,b Innovation Center for Big Data and Digital Convergence, Yuan Ze University , Taoyuan , Taiwan, Republic of China
| | - Chiung-Yi Wu
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,b Innovation Center for Big Data and Digital Convergence, Yuan Ze University , Taoyuan , Taiwan, Republic of China
| | - Chia-Li Chen
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,f Department of Information Management, Lung Hwa University of Science and Technology , New Taipei City , Taiwan, Republic of China
| | - Ching-Yen Kuo
- a Department of Information Management, Yuan Ze University , Taoyuan , Taiwan, Republic of China.,g Department of Medical Administration, Taoyuan General Hospital, Ministry of Health and Welfare , Taoyuan , Taiwan, Republic of China
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Witonsky J, Abraham R, Toh J, Desai T, Shum M, Rosenstreich D, Jariwala SP. The association of environmental, meteorological, and pollen count variables with asthma-related emergency department visits and hospitalizations in the Bronx. J Asthma 2018; 56:927-937. [PMID: 30207818 DOI: 10.1080/02770903.2018.1514627] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: To better understand how meteorological variables, air quality variables, and pollen counts collectively contribute to asthma-related emergency department visits (AREDV) and asthma-related hospitalizations (ARH) among pediatric and adult patients in the New York City borough of the Bronx. Methods: The numbers of daily adult and pediatric AREDV and ARH from 2001 to 2008 were obtained from three Bronx hospitals. After removing outliers, interpolating missing data, and standardizing variable values by scaling the data using z-scores, data were analyzed using Spearman rank tests and linear regression models for the full year and each season. Results: There were a total of 42,065 AREDV and 1,664 ARH at both Bronx hospitals. With the exception of a spring peak in AREDVs, AREDVs and ARHs follow a cyclical pattern, climbing in the fall, plateauing in the winter, dropping in the spring, and reaching a low in the summer. Among the 11 air quality, meteorological, and pollen count variables, temperature and tree pollen made the greatest contribution to AREDV with scaled coefficients of -0.337 and 0.311 respectively; equating to an additional AREDV for every 5.0-unit decrease in temperature and an additional AREDV for every 186.0-unit increase in tree pollen. These two variables were confirmed to have independent associations with AREDV prior to the data interpolation. Grass pollen was also found to have a relatively large contribution to AREDV during the summer with a scaled coefficient of 0.314, equating to an additional AREDV for every 2.3-unit increase in grass pollen. Conclusion: There are distinct peaks of increased AREDVs that are closely associated with increased tree pollen counts in the spring and decreasing temperatures in the fall. Early anticipation of these air quality, meteorological, and pollen factor changes based on ongoing surveillance could potentially guide clinical practice and minimize AREDVs in the Bronx.
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Affiliation(s)
- Jonathan Witonsky
- a Department of Pediatrics, University of California , San Francisco , CA , USA ; Albert Einstein College of Medicine, Bronx, NY, USA
| | - Ryan Abraham
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Jennifer Toh
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Tulsi Desai
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Mili Shum
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - David Rosenstreich
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
| | - Sunit P Jariwala
- b Division of Allergy/Immunology, Albert Einstein College of Medicine ; Bronx , NY , USA
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Khan MS, Coulibaly S, Matsumoto T, Yano Y, Miura M, Nagasaka Y, Shima M, Yamagishi N, Wakabayashi K, Watanabe T. Association of airborne particles, protein, and endotoxin with emergency department visits for asthma in Kyoto, Japan. Environ Health Prev Med 2018; 23:41. [PMID: 30153806 PMCID: PMC6114267 DOI: 10.1186/s12199-018-0731-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 08/13/2018] [Indexed: 01/23/2023] Open
Abstract
Background The health effects of biological aerosols on the respiratory system are unclear. The purpose of this study was to clarify the association of airborne particle, protein, and endotoxin with emergency department visits for asthma in Kyoto City, Japan. Methods We collected data on emergency department visits at a hospital in Kyoto from September 2014 to May 2016. Fine (aerodynamic diameter ≤ 2.5 μm) and coarse (≥ 2.5 μm) particles were collected in Kyoto, and protein and endotoxin levels were analyzed. The association of the levels of particles, protein, endotoxin, and meteorological factors (temperature, relative humidity, wind speed, and air pressure) with emergency department visits for asthma was estimated. Results There were 1 to 15 emergency department visits for asthma per week, and the numbers of visits increased in the autumn and spring, namely many weeks in September, October, and April. Weekly concentration of protein in fine particles was markedly higher than that in coarse particles, and protein concentration in fine particles was high in spring months. Weekly endotoxin concentrations in fine and coarse particles were high in autumn months, including September 2014 and 2015. Even after adjusting for meteorological factors, the concentrations of coarse particles and endotoxin in both particles were significant factors on emergency department visits for asthma. Conclusions Our results suggest that atmospheric coarse particles and endotoxin are significantly associated with an increased risk of asthma exacerbation. Electronic supplementary material The online version of this article (10.1186/s12199-018-0731-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mohammad Shahriar Khan
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Souleymane Coulibaly
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Takahiro Matsumoto
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan
| | - Yoshitaka Yano
- Education and Research Center for Clinical Pharmacy, Kyoto Pharmaceutical University, 5 Misasagi-Nakauchcho, Yamashinaku, Kyoto, 607-8414, Japan
| | - Makoto Miura
- Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashinaku, Kyoto, 607-8062, Japan
| | - Yukio Nagasaka
- Rakuwakai Otowa Hospital, 2 Otowachinji-cho, Yamashinaku, Kyoto, 607-8062, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, 1-1 Mukogawacho, Nishinomiya, Hyogo, 663-8501, Japan
| | - Nobuyuki Yamagishi
- Faculty of Pharmaceutical Sciences, Setsunan University, 45-1 Nagaotogecho, Hirakata, Osaka, 573-0101, Japan
| | - Keiji Wakabayashi
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan.,Graduate Division of Nutritional and Environmental Sciences, University of Shizuoka, 52-1 Yada, Suruga-ku, Shizuoka, 422-8526, Japan
| | - Tetsushi Watanabe
- Department of Public Health, Kyoto Pharmaceutical University, 1 Misasagi-Shichonocho, Yamashinaku, Kyoto, 607-8412, Japan.
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Martínez-Rivera C, Garcia-Olivé I, Stojanovic Z, Radua J, Ruiz Manzano J, Abad-Capa J. Association between air pollution and asthma exacerbations in Badalona, Barcelona (Spain), 2008-2016. Med Clin (Barc) 2018; 152:333-338. [PMID: 30149947 DOI: 10.1016/j.medcli.2018.06.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 06/18/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVE Air pollution has been widely associated with respiratory diseases. Nevertheless, association between air pollution and exacerbations of asthma in our area has been less studied. To analyse the effect of air pollution on exacerbations of asthma in Badalona. MATERIAL AND METHODS This was an observational study conducted in Badalona. The number of daily hospital admissions and accident and emergency visits related to exacerbation of asthma between 2008 and 2016 was obtained. We used simple Poisson regressions to test the effects of daily mean temperature, atmospheric pressure, relative humidity, and NO2, SO2 and CO levels on asthma-related emergencies and hospitalisations the same day and 1-4 days after. All p-values were corrected for multiple comparisons. RESULTS The number of hospitalisations was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 0, 1, 2 and 4) and atmospheric pressure (lags 2 and 3). The number of accident and emergency visits was associated with low temperature (lags 0 to 4) and higher levels of NO2 (lags 2, 3 and 4). CONCLUSIONS The number of accident and emergency visits and hospitalisations for exacerbation of asthma is associated with higher levels of NO2 and with lower temperatures.
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Affiliation(s)
- Carlos Martínez-Rivera
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Ignasi Garcia-Olivé
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España.
| | - Zoran Stojanovic
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Joaquim Radua
- Department of Statistics, FIDMAG Research Unit, Sant Boi de Llobregat, Barcelona, España; Ciber de Salud Mental (CiberSam), Madrid, España; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Estocolmo, Suecia; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Juan Ruiz Manzano
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
| | - Jorge Abad-Capa
- Servicio de Neumología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España; Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, España; Departament de Medicina, Universitat Autònoma de Barcelona, Bellatera, Barcelona, España; Ciber de Enfermedades Respiratorias (CibeRes), Bunyola, Mallorca, España
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Luo L, Liao C, Zhang F, Zhang W, Li C, Qiu Z, Huang D. Applicability of internet search index for asthma admission forecast using machine learning. Int J Health Plann Manage 2018; 33:723-732. [PMID: 29656461 DOI: 10.1002/hpm.2525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE This study aimed to determine whether a search index could provide insight into trends in asthma admission in China. An Internet search index is a powerful tool to monitor and predict epidemic outbreaks. However, whether using an internet search index can significantly improve asthma admissions forecasts remains unknown. The long-term goal is to develop a surveillance system to help early detection and interventions for asthma and to avoid asthma health care resource shortages in advance. METHODS In this study, we used a search index combined with air pollution data, weather data, and historical admissions data to forecast asthma admissions using machine learning. RESULTS Results demonstrated that the best area under the curve in the test set that can be achieved is 0.832, using all predictors mentioned earlier. CONCLUSION A search index is a powerful predictor in asthma admissions forecast, and a recent search index can reflect current asthma admissions with a lag-effect to a certain extent. The addition of a real-time, easily accessible search index improves forecasting capabilities and demonstrates the predictive potential of search index.
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Affiliation(s)
- Li Luo
- Business School, Sichuan University, China
| | | | | | - Wei Zhang
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, China
| | - Chunyang Li
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, China
| | - Zhixin Qiu
- Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, China
| | - Debin Huang
- Chengdu Medical Insurance Administration, China
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Air pollutants and atmospheric pressure increased risk of ED visit for spontaneous pneumothorax. Am J Emerg Med 2018; 36:2249-2253. [PMID: 29685359 DOI: 10.1016/j.ajem.2018.04.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 04/10/2018] [Accepted: 04/11/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To investigate the impact of short-term exposure to air pollutants and meteorological variation on ED visits for primary spontaneous pneumothorax (PSP). MATERIAL AND METHODS We retrospectively identified PSP cases that presented at the ED of our tertiary center between January 2015 and September 2016. We classified the days into three types: no PSP day (0 case/day), sporadic days (1-2 cases/day), and cluster days (PSP, ≥3 cases/day). Association between the daily incidence of PSP with air pollutants and meteorological data were determined using Poisson generalized-linear-model to calculate incidence rate ratio (IRRs) and the use of time-series (lag-1 [the cumulative air pollution level on the previous day of PSP], lag-2 [two days ago], and lag-3 [three days ago]). RESULTS Using multivariate logistic regression analysis, O3 (p = 0.010), NO2 (p = 0.047), particulate matters (PM)10 (p = 0.021), and PM2.5 (p = 0.008) were significant factors of PSP occurrence. When the concentration of O3, NO2, PM10, and PM2.5 were increased, PSP IRRs increased approximately 15, 16, 3, and 5-fold, respectively. With the time-series analyses, atmospheric pressure in lag-3 was significantly lower and in lag-2, was significantly higher in PSP days compared with no PSP days. Among air pollutant concentrations, O3 in lag-1 (p = 0.017) and lag-2 (p = 0.038), NO2 in lag-1 (p = 0.015) and lag-2 (p = 0.009), PM10 in lag-1 (p = 0.012), and PM2.5 in lag-1 (p = 0.021) and lag-2 (p = 0.032) were significantly different between no PSP and PSP days. CONCLUSION Increased concentrations of air pollutants and abrupt change in atmospheric pressure were significantly associated with increased IRR of PSP.
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Xu Z, Crooks JL, Davies JM, Khan AF, Hu W, Tong S. The association between ambient temperature and childhood asthma: a systematic review. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2018; 62:471-481. [PMID: 29022096 DOI: 10.1007/s00484-017-1455-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 09/18/2017] [Accepted: 09/24/2017] [Indexed: 05/09/2023]
Abstract
The objectives of this study are to review available information on the association between ambient temperature and childhood asthma, and to elucidate the possible underlying mechanisms of this relationship. A systematic review was conducted based on the papers retrieved from four databases, including PubMed, ProQuest, ScienceDirect, and Scopus. Papers examining the association of absolute temperature or temperature variation with childhood asthma published from 1 January 2000 to 31 December 2016 were included. Thirteen papers have quantified the effect of absolute temperature on childhood asthma, and six papers have examined the effect of intra- or inter-day temperature variation on childhood asthma. All studies were conducted in urban areas. Aeroallergen sensitizations were only considered in the analyses of one study. Discrepancy existed in the significance of the relationship between absolute temperature and childhood asthma, and also in the shape of this relationship (i.e. linear or non-linear) and whether temperature effects were lagged. Increasing evidence is suggesting non-linear relationship between absolute temperature and childhood asthma. Future research should investigate the burden of childhood asthma specifically attributable to extreme temperatures and temperature variation using advanced statistical approach, particularly in rural areas, after properly considering aeroallergens and air pollution. Projecting future burden of childhood asthma under climate change scenarios is also warranted.
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Affiliation(s)
- Zhiwei Xu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia.
| | | | - Janet Mary Davies
- School of Biomedical Sciences & Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Al Fazal Khan
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Wenbiao Hu
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
| | - Shilu Tong
- School of Public Health and Social Work & Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, 4059, Australia
- School of Public Health and Institute of Environment and Human Health, Anhui Medical University, Hefei, China
- Shanghai Children's Medical Centre, Shanghai Jiao-Tong University, Shanghai, China
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Cong X, Xu X, Zhang Y, Wang Q, Xu L, Huo X. Temperature drop and the risk of asthma: a systematic review and meta-analysis. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:22535-22546. [PMID: 28804860 DOI: 10.1007/s11356-017-9914-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 08/03/2017] [Indexed: 02/05/2023]
Abstract
The relationship between asthma and temperature changes remains controversial. The aim of this study was to investigate the association between temperature changes and the risk of asthma. A total of 26 studies (combined total number of subjects N > 26 million), covering 13 countries and Costa Rica, were identified by using a series of keywords in different combinations and searching the papers in PubMed, EMBSEA, Web of Science, MEDLINE, AIM, LILACS, and WPRIM before February 2016. Most of the papers were published in English. Random-effects meta-analyses were performed to evaluate the effect of temperature drop on risk of asthma. Several secondary analyses were also calculated based on stratification for different age, season, latitude, and region on risk of asthma. The odds ratio (OR) estimate between temperature drop and asthma was 1.05 (95% CI 1.02, 1.08) in the meta-analysis. For children, the overall OR was 1.09 (95% CI 1.03, 1.15). Dose-effect analyses showed stronger associations in asthma risk for each 1°1 °C decrement in short-term temperature (OR 1.055, 95% CI 1.00, 1.11). Further stratifications showed that winter (OR 1.03, 95% CI 1.01, 105) and low latitude (OR 1.72, 95% CI 1.23, 2.41) have a statistically significant association with the increased risk of asthma. Exposure of people to short-term temperature drop (per 1 °C decrement) was significantly associated with the risk of lower respiratory tract infections (LRTI) with asthma (OR 1.02, 95% CI 1.00, 1.04). Results suggest an adverse effect of temperature drop on asthma risk, especially in children and low-latitude areas. It may be opportune to consider the preventive actions against temperature drop, including simple face masks, to decrease the risk of asthma.
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Affiliation(s)
- Xiaowei Cong
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xijin Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China.
- Department of Cell Biology and Genetics, Shantou University Medical College, Shantou, Guangdong, 515041, China.
| | - Yuling Zhang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Qihua Wang
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Long Xu
- Laboratory of Environmental Medicine and Developmental Toxicology, and Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou University Medical College, Shantou, Guangdong, 515041, China
| | - Xia Huo
- School of Environment, Guangzhou Key Laboratory of Environmental Exposure and Health, Guangdong Key Laboratory of Environmental Pollution and Health, Jinan University, Guangzhou, Guangdong, 510632, China.
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Markov Chain-Based Acute Effect Estimation of Air Pollution on Elder Asthma Hospitalization. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:2463065. [PMID: 29147496 PMCID: PMC5632917 DOI: 10.1155/2017/2463065] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/30/2017] [Indexed: 02/05/2023]
Abstract
Background Asthma caused substantial economic and health care burden and is susceptible to air pollution. Particularly, when it comes to elder asthma patient (older than 65), the phenomenon is more significant. The aim of this study is to investigate the Markov-based acute effects of air pollution on elder asthma hospitalizations, in forms of transition probabilities. Methods A retrospective, population-based study design was used to assess temporal patterns in hospitalizations for asthma in a region of Sichuan province, China. Approximately 12 million residents were covered during this period. Relative risk analysis and Markov chain model were employed on daily hospitalization state estimation. Results Among PM2.5, PM10, NO2, and SO2, only SO2 was significant. When air pollution is severe, the transition probability from a low-admission state (previous day) to high-admission state (next day) is 35.46%, while it is 20.08% when air pollution is mild. In particular, for female-cold subgroup, the counterparts are 30.06% and 0.01%, respectively. Conclusions SO2 was a significant risk factor for elder asthma hospitalization. When air pollution worsened, the transition probabilities from each state to high admission states increase dramatically. This phenomenon appeared more evidently, especially in female-cold subgroup (which is in cold season for female admissions). Based on our work, admission amount forecast, asthma intervention, and corresponding healthcare allocation can be done.
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29
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City housing atmospheric pollutant impact on emergency visit for asthma: A classification and regression tree approach. Respir Med 2017; 132:1-8. [PMID: 29229079 DOI: 10.1016/j.rmed.2017.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 08/29/2017] [Accepted: 09/08/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Particulate matter, nitrogen dioxide (NO2) and ozone are recognized as the three pollutants that most significantly affect human health. Asthma is a multifactorial disease. However, the place of residence has rarely been investigated. We compared the impact of air pollution, measured near patients' homes, on emergency department (ED) visits for asthma or trauma (controls) within the Provence-Alpes-Côte-d'Azur region. METHODS Variables were selected using classification and regression trees on asthmatic and control population, 3-99 years, visiting ED from January 1 to December 31, 2013. Then in a nested case control study, randomization was based on the day of ED visit and on defined age groups. Pollution, meteorological, pollens and viral data measured that day were linked to the patient's ZIP code. RESULTS A total of 794,884 visits were reported including 6250 for asthma and 278,192 for trauma. Factors associated with an excess risk of emergency visit for asthma included short-term exposure to NO2, female gender, high viral load and a combination of low temperature and high humidity. CONCLUSION Short-term exposures to high NO2 concentrations, as assessed close to the homes of the patients, were significantly associated with asthma-related ED visits in children and adults.
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Kullmann T, Szipőcs A. Variability of breath condensate pH may contribute to the better understanding of non-allergic seasonal respiratory diseases. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2017; 61:1703-1708. [PMID: 28676946 DOI: 10.1007/s00484-017-1397-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 06/07/2017] [Accepted: 06/12/2017] [Indexed: 06/07/2023]
Abstract
The seasonal variability of certain non-allergic respiratory diseases is not clearly understood. Analysis of the breath condensate, the liquid that can be collected by breathing into a cold tube, has been proposed to bring closer to the understanding of airway pathologies. It has been assumed, that (1) airway lining fluid was a stable body liquid and (2) the breath condensate samples were representative of the airway lining fluid. Research was focussed on the identification of biomarkers indicative of respiratory pathologies. Despite 30 years of extended investigations breath condensate analysis has not gained any clinical implementation so far. The pH of the condensate is the characteristic that can be determined with the highest reproducibility. The present paper shows, that contrary to the initial assumptions, breath condensate is not a representative of the airway lining fluid, and the airway lining fluid is not a stable body liquid. Condensate pH shows baseline variability and it is influenced by drinking and by the ambient temperature. The changes in condensate pH are linked to changes in airway lining fluid pH. The variability of airway lining fluid pH may explain seasonal incidence of certain non-allergic respiratory diseases such as the catching of a common cold and the increased incidence of COPD exacerbations and exercise-induced bronchoconstriction in cold periods.
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Affiliation(s)
- Tamás Kullmann
- Department of Oncoradiology, Petz Aladár County Teaching Hospital, Vasvári Pál u. 2-4, Győr, 9024, Hungary.
| | - Annamária Szipőcs
- Department of Pulmonology, Petz Aladár County Teaching Hospital, Győr, Hungary
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Ma TT, Zhuang Y, Gong HY, Yii AC, Wang XY, Shi HZ. Predictive value of respiratory symptoms for the diagnosis of pollen-induced seasonal asthma among children and adults in Inner Mongolia. Ther Clin Risk Manag 2017; 13:967-974. [PMID: 28831262 PMCID: PMC5552151 DOI: 10.2147/tcrm.s138355] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background The diagnosis of asthma is made on the basis of variable respiratory symptoms and supported by objective evidence of variable airflow limitation. However, spirometry and bronchoprovocation tests may not be routinely available in resource-scarce settings or in the context of large-scale epidemiological studies. There is a gap in knowledge about the predictive value of respiratory symptoms for the diagnosis of pollen-induced asthma. Objective The aim of this study was to investigate the predictive value of self-reported respiratory symptoms for diagnosing pollen-induced asthma. Patients and methods We recruited 1,161 patients with respiratory symptoms who presented to the respiratory medicine outpatient clinic of two central hospitals in Inner Mongolia during the pollen season of July–September 2015. All patients were interviewed by a respiratory physician and completed a questionnaire survey, lung function tests and skin prick tests for common inhaled allergens. Results A total of 392 patients (33.8%) were diagnosed with asthma and 292 (25.2%, 160 adults, 132 children) with pollen-induced asthma. Respiratory symptoms of cough, wheezing, dyspnea, chest pain and nocturnal awakenings due to breathlessness were all associated with increased odds of being diagnosed with pollen-induced asthma, with cough being the most common symptom in both adults and children, giving a sensitivity of 90.6% in adults and 88.6% in children. Wheezing was the most specific symptom (78% and 89.5% in adults and children, respectively) compared to other symptoms. Overall, the positive predictive value of respiratory symptoms was poor for diagnosing pollen-induced asthma, with the exception of wheezing in children which had a high positive predictive value of 72.7%. Conclusion Cough was the predominant symptom in adults and children with pollen-induced asthma. Wheezing was a reliable predictor of pollen-induced asthma in children. In adults, respiratory symptoms were not sufficiently reliable for diagnosing pollen-induced asthma.
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Affiliation(s)
- Ting Ting Ma
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University.,Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University.,Center of Medical Research, Beijing Institute of Respiratory Diseases
| | - Yan Zhuang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University
| | - Hai Ying Gong
- Fangshan District Center for Disease Control and Prevention, Beijing, China
| | - Anthony Chauang Yii
- Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore, Singapore
| | - Xue Yan Wang
- Department of Allergy, Beijing Shijitan Hospital, Capital Medical University
| | - Huan Zhong Shi
- Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Beijing Institute of Respiratory Medicine, Capital Medical University.,Center of Medical Research, Beijing Institute of Respiratory Diseases
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32
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Mazenq J, Dubus JC, Gaudart J, Charpin D, Nougairede A, Viudes G, Noel G. Air pollution and children's asthma-related emergency hospital visits in southeastern France. Eur J Pediatr 2017; 176:705-711. [PMID: 28382539 DOI: 10.1007/s00431-017-2900-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 03/18/2017] [Accepted: 03/23/2017] [Indexed: 11/25/2022]
Abstract
UNLABELLED Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM10 and PM2.5, meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. CONCLUSION PM10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.
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Affiliation(s)
- Julie Mazenq
- Pediatric Pulmonology Department, Timone Children's Hospital, 264 rue Saint Pierre, 13005, Marseille, France.
| | - Jean-Christophe Dubus
- Pediatric Pulmonology Department, Timone Children's Hospital, 264 rue Saint Pierre, 13005, Marseille, France
| | - Jean Gaudart
- Aix-Marseille University, UMR912 SESSTIM (AMU-IRD-INSERM), Marseille, France
| | - Denis Charpin
- Pulmonology and Allergology Department, Hôpital Nord, Marseille, France
| | - Antoine Nougairede
- IRD French Institute of Research for Development, EHESP, French School of Public Health, EPV UMR_D 190 "Emergence des Pathologies Virales", Aix Marseille University, Marseille, France.,University Mediterranean Hospital Institute for Infections, Marseille, France
| | - Gilles Viudes
- Regional Emergencies Observatory, Provence-Alpes-Cote d'Azur region (ORU PACA), Hyères, France
| | - Guilhem Noel
- Regional Emergencies Observatory, Provence-Alpes-Cote d'Azur region (ORU PACA), Hyères, France.,Pediatric Emergency Department, Hôpital Nord, Marseille, France
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Abstract
OBJECTIVE The aim of this study was to determine whether patient volume in an urban pediatric emergency department (ED) can be predicted based on holidays and thus aid in staffing and resource allocation. METHODS Log-in dates and times were obtained for all patients seen in an urban pediatric ED between July 1, 2006, and June 30, 2013. Visits were coded for the day of the week, tour (ie, shift), and season and whether they occurred on a holiday or nonholiday. Comparisons between the median number of patient visits on holidays versus nonholidays by day of the week, tour, and season were performed. Additional comparisons on 5 Monday holidays as well as New Year's Day, Thanksgiving, and Christmas Day were also performed. Data were presented as medians with interquartile ranges. Group comparisons were performed via using Mann-Whitney U tests and Kruskal-Wallis tests (α = 0.05, 2 tailed). RESULTS There were 223,677 total patient visits, with a mean yearly census of 31,954. The median daily volume was 85, peaking on Mondays (median, 99). The summer season demonstrated the fewest number of patient visits (median, 74) relative to the other seasons (medians, 89-91). Compared with nonholidays, there were fewer patient visits on Thanksgiving and Christmas Day and in the late afternoon and evening on other individual holidays. CONCLUSIONS Fewer patient visits on Thanksgiving and Christmas Days, as well as during the late afternoon/evening on several other holidays, point to the possibility of small adjustments to staffing in ways that can more efficiently balance demand with available resources.
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Nakao M, Yamauchi K, Ishihara Y, Solongo B, Ichinnorov D. Effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with chronic respiratory disease in Ulaanbaatar: pilot study for the comparison of the cold and warm seasons. SPRINGERPLUS 2016; 5:1817. [PMID: 27803849 PMCID: PMC5069213 DOI: 10.1186/s40064-016-3481-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2016] [Accepted: 10/05/2016] [Indexed: 12/21/2022]
Abstract
Background This study was performed to investigate the effects of air pollution and seasonality on the respiratory symptoms and health-related quality of life (HR-QoL) of outpatients with respiratory diseases in Ulaanbaatar, Mongolia. Subjects were outpatients who visited the hospital with chronic obstructive pulmonary diseases (COPD) or bronchial asthma (BA) in March. Their symptoms and HR-QoL were evaluated using a questionnaire including the SF-36v2 and COOP/WONCA charts in March, May and July. PM2.5 was sampled in March and July in Ulaanbaatar, and its composition was analyzed. Results Patients with COPD or BA showed higher prevalence of respiratory symptoms than the control subjects in each month. For HR-QoL, all subscales worsened in the patients than in the control group in March. Although the HR-QoL of the COPD and control groups were not significantly changed through the surveys, some subscales of the BA group showed remarkable improvement in July as compared to March. Daily means of PM2.5 in March were significantly higher than those in July. Carbon and ionic component concentrations, except for magnesium and calcium ions, were significantly higher in March than July. Mass concentrations of some metallic components were also significantly higher in March than July. The percentage of nitrate ion in PM2.5 was significantly higher in March when compared to that in July. Conclusions These results suggested that the symptoms in the COPD and BA groups were caused by the disease, and the association with air pollution or seasonality remained unclear. However, the effects of air pollution and seasonality on the HR-QoL were significant in the patients with BA. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-3481-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Motoyuki Nakao
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Keiko Yamauchi
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Yoko Ishihara
- Department of Public Health, School of Medicine, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011 Japan
| | - Bandi Solongo
- Department of Respiratory Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
| | - Dashtseren Ichinnorov
- Department of Respiratory Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia
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Lam HCY, Li AM, Chan EYY, Goggins WB. The short-term association between asthma hospitalisations, ambient temperature, other meteorological factors and air pollutants in Hong Kong: a time-series study. Thorax 2016; 71:1097-1109. [PMID: 27343213 DOI: 10.1136/thoraxjnl-2015-208054] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 05/20/2016] [Accepted: 06/06/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Previous studies have found associations between meteorological variables and asthma hospitalisations but the nature of these associations has varied and few studies have been done in subtropical areas or evaluated effect modification by age. OBJECTIVES This study aimed to evaluate associations between asthma hospitalisations and meteorological factors and to assess effect modification of these associations by age and season in Hong Kong. METHODS Poisson generalised additive models combined with distributed lag nonlinear models and piecewise linear models were used to model associations between daily asthma hospitalisations from 2004 to 2011 and meteorological factors and air pollutants, adjusting for day of week, seasonality and trend. Subgroup analyses by age and season were performed. RESULTS In the hot season, hospitalisations were lowest at 27°C, rose to a peak at 30°C, then plateaued between 30°C and 32°C. The cumulative relative risk for lags 0-3 days (RRlag0-3) for 30°C vs 27°C was 1.19 (95% CI 1.06 to 1.34). In the cold season, temperature was negatively associated with asthma hospitalisations. The cumulative RRlag0-3 for 12°C vs 25°C was 1.33 (95% CI 1.13 to 1.58). Adult admissions were most sensitive to temperatures in both seasons while admissions among children under 5 were least associated. Higher humidity and ozone levels in the hot season, and low humidity in the cold season were also associated with more asthma admissions. CONCLUSIONS People with asthma should avoid exposure to adverse conditions by limiting outdoor activities during periods of extreme temperatures, combinations of high humidity and high temperature, and low humidity and low temperature, and high ozone levels.
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Affiliation(s)
- Holly Ching-Yu Lam
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Albert Martin Li
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - Emily Ying-Yang Chan
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
| | - William Bernard Goggins
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong SAR
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Li K, Ni H, Yang Z, Wang Y, Ding S, Wen L, Yang H, Cheng J, Su H. Effects of temperature variation between neighbouring days on daily hospital visits for childhood asthma: a time-series analysis. Public Health 2016; 136:133-40. [PMID: 27161494 DOI: 10.1016/j.puhe.2016.04.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/05/2016] [Accepted: 04/01/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To identify the relationship between temperature variation between neighbouring days (TVN) and hospital visits for childhood asthma in age- and sex-specific groups. STUDY DESIGN An ecological design was used to explore the effect of TVN on hospital visits for childhood asthma. METHODS A Poisson generalised linear regression model combined with a distributed lag non-linear model was used to analyse the association between TVN and hospital visits for childhood asthma. All hospital visits for childhood asthma from June 2010 to July 2013 were included (n = 17,022). Daily climate data were obtained from Hefei Meteorological Bureau. RESULTS A significant correlation was found between TVN and hospital visits for childhood asthma in age- and sex-specific groups. For different gender groups, the effect of TVN on childhood asthma was the greatest at 3 and 5 days lag for males and females. For different age groups, the effect of TVN on childhood asthma was the greatest at 1 and 5 days lag for 0-4 years and 5-14 years children, respectively. A 1 °C increase in TVN was associated with a 4.2% (95% confidence interval 0.9-7.6%) increase in hospital visits for childhood asthma. CONCLUSIONS TVN is associated with hospital visits for childhood asthma. Once the temperature change rapidly, guardians will be urged to pay more attention to their children's health, which may reduce the morbidity of childhood asthma.
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Affiliation(s)
- K Li
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - H Ni
- Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Z Yang
- Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - Y Wang
- Anhui Provincial Children's Hospital, Hefei, Anhui, China
| | - S Ding
- The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - L Wen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - H Yang
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - J Cheng
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - H Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, China.
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Altzibar JM, Tamayo-Uria I, De Castro V, Aginagalde X, Albizu MV, Lertxundi A, Benito J, Busca P, Antepara I, Landa J, Mokoroa O, Dorronsoro M. Epidemiology of asthma exacerbations and their relation with environmental factors in the Basque Country. Clin Exp Allergy 2016; 45:1099-108. [PMID: 25258133 DOI: 10.1111/cea.12419] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Revised: 07/22/2014] [Accepted: 08/19/2014] [Indexed: 12/01/2022]
Abstract
BACKGROUND Asthma is a highly prevalent chronic inflammatory disease characterised by reversible airflow obstruction and hyperreactivity and inflammation of the airways. Factors that cause and/or trigger asthma attacks include host-related factors (genetic predisposition, obesity and sex) and environmental factors (allergens, infections, occupational sensitisation, smoking status, pollution and diet). OBJECTIVE To describe the epidemiology of asthma exacerbations (AEs) in the Basque Country and to explore its relationship with potentially associated environmental variables. We studied a total of 31,579 emergency department (ED) visits and 28,189 hospitalisations due to asthma. We describe the trends, incidence, seasonality and the influence of age and sex, as well as of exposure to NO2 , CO, PM, O3 , and pollen, temperature, relative humidity and flu status. We calculated the Pearson's R correlation coefficient for the study variables. RESULTS The incidence was 486 and 88.9 cases per 100,000 people for ED visits and hospitalisations, respectively. Slightly over half (53.5%) of the ED cases were male, while females represented 62.6% of the hospital admissions. Hospitalisations are tending to decrease in children and increase in over 64-year-olds. Peaks in cases occur at the beginning of autumn in children and in winter in adults. AEs were correlated positively with exposure to NO2 , CO and to the influenza virus and negatively with temperature and exposure to O3 . These relationships vary, however, with age and season. CONCLUSIONS AND CLINICAL RELEVANCE Rates of hospitalisation for AEs and trends in these rates over time are different in adults and children with the patterns varying by sex, season and environmental conditions.
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Affiliation(s)
- J M Altzibar
- Public Health Division of Gipuzkoa, Department of Health of the Regional Government of the Basque Country, Donostia, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Biodonostia Research Institute, Donostia, Spain
| | - I Tamayo-Uria
- Public Health Division of Gipuzkoa, Department of Health of the Regional Government of the Basque Country, Donostia, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Biodonostia Research Institute, Donostia, Spain
| | - V De Castro
- Public Health Division of Bizkaia, Department of Health of the Regional Government of the Basque Country, Bilbo, Spain
| | - X Aginagalde
- Laboratory of Public Health, Regional Government of the Basque Country, Bilbo, Spain
| | - M V Albizu
- Environmental Management, Regional Government of the Basque Country, Bilbo, Spain
| | - A Lertxundi
- Biodonostia Research Institute, Donostia, Spain.,Department of Preventive Medicine and Public Health, University of the Basque Country UPV/EHU, Leioa, Spain
| | - J Benito
- Paediatric Emergency Department, Cruces University Hospital, Basque Health Service, Bilbo, Spain
| | - P Busca
- Emergency Department, Donostia University Hospital, Basque Health Service, Donostia, Spain
| | - I Antepara
- Allergology Department, Basurto University Hospital, Basque Health Service, Bilbo, Spain
| | - J Landa
- Department of Paediatrics, Donostia University Hospital, Basque Health Service, Donostia, Spain
| | - O Mokoroa
- Public Health Division of Alava, Department of Health of the Regional Government of the Basque Country, Vitoria-Gasteiz, Spain
| | - M Dorronsoro
- Public Health Division of Gipuzkoa, Department of Health of the Regional Government of the Basque Country, Donostia, Spain.,CIBER of Epidemiology and Public Health, Madrid, Spain.,Biodonostia Research Institute, Donostia, Spain
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Zheng XY, Ding H, Jiang LN, Chen SW, Zheng JP, Qiu M, Zhou YX, Chen Q, Guan WJ. Association between Air Pollutants and Asthma Emergency Room Visits and Hospital Admissions in Time Series Studies: A Systematic Review and Meta-Analysis. PLoS One 2015; 10:e0138146. [PMID: 26382947 PMCID: PMC4575194 DOI: 10.1371/journal.pone.0138146] [Citation(s) in RCA: 269] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2015] [Accepted: 08/25/2015] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Air pollution constitutes a significant stimulus of asthma exacerbations; however, the impacts of exposure to major air pollutants on asthma-related hospital admissions and emergency room visits (ERVs) have not been fully determined. OBJECTIVE We sought to quantify the associations between short-term exposure to air pollutants [ozone (O3), carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter ≤10 μm (PM10) and PM2.5] and the asthma-related emergency room visits (ERV) and hospitalizations. METHODS Systematic computerized searches without language limitation were performed. Pooled relative risks (RRs) and 95% confidence intervals (95%CIs) were estimated using the random-effect models. Sensitivity analyses and subgroup analyses were also performed. RESULTS After screening of 246 studies, 87 were included in our analyses. Air pollutants were associated with significantly increased risks of asthma ERVs and hospitalizations [O3: RR(95%CI), 1.009 (1.006, 1.011); I2 = 87.8%, population-attributable fraction (PAF) (95%CI): 0.8 (0.6, 1.1); CO: RR(95%CI), 1.045 (1.029, 1.061); I2 = 85.7%, PAF (95%CI): 4.3 (2.8, 5.7); NO2: RR(95%CI), 1.018 (1.014, 1.022); I2 = 87.6%, PAF (95%CI): 1.8 (1.4, 2.2); SO2: RR(95%CI), 1.011 (1.007, 1.015); I2 = 77.1%, PAF (95%CI): 1.1 (0.7, 1.5); PM10: RR(95%CI), 1.010 (1.008, 1.013); I2 = 69.1%, PAF (95%CI): 1.1 (0.8, 1.3); PM2.5: RR(95%CI), 1.023 (1.015, 1.031); I2 = 82.8%, PAF (95%CI): 2.3 (1.5, 3.1)]. Sensitivity analyses yielded compatible findings as compared with the overall analyses without publication bias. Stronger associations were found in hospitalized males, children and elderly patients in warm seasons with lag of 2 days or greater. CONCLUSION Short-term exposures to air pollutants account for increased risks of asthma-related ERVs and hospitalizations that constitute a considerable healthcare utilization and socioeconomic burden.
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Affiliation(s)
- Xue-yan Zheng
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Hong Ding
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Li-na Jiang
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Shao-wei Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Jin-ping Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
| | - Min Qiu
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Ying-xue Zhou
- Department of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Qing Chen
- Department of Epidemiology, School of Public Health and Tropical Medicine, Southern Medical University, Guangdong, China
| | - Wei-jie Guan
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical University, Guangzhou, China
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Brzezińska-Pawłowska OE, Rydzewska AD, Łuczyńska M, Majkowska-Wojciechowska B, Kowalski ML, Makowska JS. Environmental factors affecting seasonality of ambulance emergency service visits for exacerbations of asthma and COPD. J Asthma 2015; 53:139-45. [PMID: 26369434 DOI: 10.3109/02770903.2015.1075547] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to assess the association of severe exacerbations of asthma and Chronic Obstructive Pulmonary Disease (COPD) requiring ambulance emergency service (AES) visits with meteorological parameters and influenza outbreaks. METHODS The records of patients calling the AES in 2007 and 2008 in the urban area of Lodz due to dyspnea were analyzed. Information on 25 daily reported meteorological parameters was obtained from the local meteorological service and data on influenza outbreaks obtained from the national surveillance service. RESULTS During the winter months, a significantly higher mean daily number of AES visits for both COPD and asthma were noticed when compared to the summer. Interestingly, the number of daily AES visits correlated with several weather parameters, and the multiple regression analysis confirmed a negative correlation with minimum temperature, mean temperature and the dew point for both diseases (R = 0.526; p < 0.01; R = 0.577; p < 0.01 and R = 0.589; p < 0.01). Furthermore, the increased number of AES visits also correlated with a new number of cases of influenza infections as reported by local influenza surveillance system (rs = 77.6%; p < 0.001 and rs = 80.8%; p < 0.001 for asthma and COPD, respectively). CONCLUSION Seasonality of AES visits for asthma and COPD are similar and seems to be related to specific weather conditions and to influenza outbreaks.
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Affiliation(s)
- Olga E Brzezińska-Pawłowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Anna D Rydzewska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marta Łuczyńska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Barbara Majkowska-Wojciechowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Marek L Kowalski
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
| | - Joanna S Makowska
- a Department of Immunology , Rheumatology and Allergy, Chair of Clinical Immunology and Microbiology, Medical University of Lodz , Łódź , Poland
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40
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Makra L, Puskás J, Matyasovszky I, Csépe Z, Lelovics E, Bálint B, Tusnády G. Weather elements, chemical air pollutants and airborne pollen influencing asthma emergency room visits in Szeged, Hungary: performance of two objective weather classifications. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2015; 59:1269-89. [PMID: 25504051 DOI: 10.1007/s00484-014-0938-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2014] [Revised: 11/16/2014] [Accepted: 11/16/2014] [Indexed: 05/19/2023]
Abstract
Weather classification approaches may be useful tools in modelling the occurrence of respiratory diseases. The aim of the study is to compare the performance of an objectively defined weather classification and the Spatial Synoptic Classification (SSC) in classifying emergency department (ED) visits for acute asthma depending from weather, air pollutants, and airborne pollen variables for Szeged, Hungary, for the 9-year period 1999-2007. The research is performed for three different pollen-related periods of the year and the annual data set. According to age and gender, nine patient categories, eight meteorological variables, seven chemical air pollutants, and two pollen categories were used. In general, partly dry and cold air and partly warm and humid air aggravate substantially the symptoms of asthmatics. Our major findings are consistent with this establishment. Namely, for the objectively defined weather types favourable conditions for asthma ER visits occur when an anticyclonic ridge weather situation happens with near extreme temperature and humidity parameters. Accordingly, the SSC weather types facilitate aggravating asthmatic conditions if warm or cool weather occur with high humidity in both cases. Favourable conditions for asthma attacks are confirmed in the extreme seasons when atmospheric stability contributes to enrichment of air pollutants. The total efficiency of the two classification approaches is similar in spite of the fact that the methodology for derivation of the individual types within the two classification approaches is completely different.
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Affiliation(s)
- László Makra
- Department of Climatology and Landscape Ecology, University of Szeged, 6701, Szeged, P.O.B. 653, Hungary,
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41
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Yamazaki S, Shima M, Yoda Y, Oka K, Kurosaka F, Shimizu S, Takahashi H, Nakatani Y, Nishikawa J, Fujiwara K, Mizumori Y, Mogami A, Yamada T, Yamamoto N. Exposure to air pollution and meteorological factors associated with children's primary care visits at night due to asthma attack: case-crossover design for 3-year pooled patients. BMJ Open 2015; 5:e005736. [PMID: 25941174 PMCID: PMC4420953 DOI: 10.1136/bmjopen-2014-005736] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE We examined the association of outdoor air pollution and meteorological parameters with primary care visits (PCVs) at night due to asthma attack. SETTING A case-crossover study was conducted in a primary care clinic in Himeji City, Japan. PARTICIPANTS Participants were 1447 children aged 0-14 years who visited the clinic with an asthma attack from April 2010 until March 2013. EXPOSURE Daily concentrations of air pollutants and meteorological parameters were measured. PRIMARY OUTCOME PCVs at night due to asthma attack. A conditional logistic regression model was used to estimate ORs of PCVs per unit increment of air pollutants or meteorological parameters (the per-unit increments of particulate matter with an aerodynamic diameter ≤2.5 µm (PM₂.₅) and ozone were 10 μg/m(3) and 10 ppb, respectively). Analyses took into consideration the effects of seasonality. RESULTS We noted an association between PCVs and daily ozone levels on the day before a PCV (OR=1.17; 95% CI 1.01 to 1.35; p=0.04), as well as between PCVs and 3-day mean ozone levels before a PCV (OR=1.29; 95% CI 1.00 to 1.46; p=0.04), from April until June. We also observed an association between PCVs and daily PM₂.₅ levels on the day before a PCV from December until March (OR=1.16; 95% CI 1.01 to 1.33; p=0.05). Meteorological parameters, such as hours of sunshine from September until November, atmospheric pressure from April until June, and temperature from April until August, were also found to be associated with PCVs. CONCLUSIONS The findings in the present study supported an association between ozone and PCVs and suggest that certain meteorological items may be associated with PCVs.
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Affiliation(s)
- Shin Yamazaki
- Department of Environmental Epidemiology, National Institute for Environmental Studies, Tsukuba, Japan
- Department of Healthcare Epidemiology, Kyoto University School of Public Health, Kyoto, Japan
| | - Masayuki Shima
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshiko Yoda
- Department of Public Health, Hyogo College of Medicine, Nishinomiya, Japan
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Qiu H, Yu ITS, Tse LA, Chan EYY, Wong TW, Tian L. Greater temperature variation within a day associated with increased emergency hospital admissions for asthma. THE SCIENCE OF THE TOTAL ENVIRONMENT 2015; 505:508-13. [PMID: 25461053 DOI: 10.1016/j.scitotenv.2014.10.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 09/19/2014] [Accepted: 10/03/2014] [Indexed: 05/24/2023]
Abstract
Asthma is one of the most common chronic conditions affecting both children and adults. Examining the health effects of environmental triggers such as temperature variation may have implications for maintenance of asthma control and prevention. We hypothesized that large diurnal temperature range (DTR) might be a source of additional environmental stress and therefore a risk factor for asthma exacerbation. Daily meteorological data, air pollution concentrations and emergency hospital admissions for asthma from 2004 to 2011 in Hong Kong were collected. Poisson regression models were used to fit the relationship between daily DTR and asthma, after adjusting for the time trend, seasonality, mean temperature, humidity, and levels of outdoor air pollution. Acute adverse effect of DTR on asthma was observed. An increment of 1 °C in DTR over lag0 to lag4 days was associated with a 2.49% (95% CI: 1.86%, 3.14%) increase in daily emergency asthma hospitalizations. The association between DTR and asthma was robust on the adjustment for daily absolute temperature and air pollution. DTR exhibited significantly greater effect in cool season. Males and female children appeared to be more vulnerable to DTR. Results supported that greater temperature variation within a day was an environmental risk factor for asthma exacerbation.
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Affiliation(s)
- Hong Qiu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ignatius Tak-Sun Yu
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Lap Ah Tse
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Emily Y Y Chan
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Tze Wai Wong
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Linwei Tian
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
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43
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Fitzgerald EF, Pantea C, Lin S. Cold spells and the risk of hospitalization for asthma: New York, USA 1991-2006. Lung 2014; 192:947-54. [PMID: 25304443 DOI: 10.1007/s00408-014-9645-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 09/22/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE A study was conducted to investigate whether prolonged periods of very cold temperatures were associated with an increased risk of hospitalization for asthma. METHODS Hospitalization admissions with a principal diagnosis of asthma were identified in New York State, USA, for the months November through April from 1991 to 2006. A cold spell was defined as three or more consecutive days where the daily mean of universal apparent temperature (UAT) within a week prior to admission was at the 10th percentile or less. The percentage change in asthma hospitalizations during and after a cold spell was compared to the average daily number of hospitalizations preceding the cold spell using time series analysis. RESULTS The average temperature during winter cold spells (December through March) was -15 °C, compared to -6 and -2 °C for cold spells in November and April, respectively. Cold spells during the winter months were associated with a mean decline of 4.9 % in asthma admissions statewide (95 % CI -7.8, -1.9 %). After a cold spell, no statistically significant changes were apparent during the winter months, but asthma hospitalizations increased after cold spells in the transitional months of November (mean = 9.6, 95 % CI 5.5, 13.9 %) and April (mean = 5.0, 95 % CI 1.2, 9.0 %). CONCLUSIONS The results suggest that during prolonged periods of severe cold asthmatics may adhere to medical guidelines and limit their exposure, thereby preventing exacerbations. They may be less likely to alter their behavior in the more moderate months of November and April.
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Affiliation(s)
- Edward F Fitzgerald
- Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, 1 University Place, Rensselaer, NY, 12144, USA,
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44
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Sanya RE, Kirenga BJ, Worodria W, Okot-Nwang M. Risk factors for asthma exacerbation in patients presenting to an emergency unit of a national referral hospital in Kampala, Uganda. Afr Health Sci 2014; 14:707-15. [PMID: 25352892 DOI: 10.4314/ahs.v14i3.29] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk factors for asthma exacerbations in patients presenting to the emergency unit of Mulago Hospital. METHODS An unmatched case-control study involving 43 cases and 43 controls was conducted from November 2011 through February 2012. Asthma patients with exacerbations presenting to Mulago hospital's emergency unit were chosen as cases. The controls were asthma patients recruited from the hospital's outpatient department who had not had an exacerbation in the past 7 days. The study variables were age, sex, level of education, adherence to treatment, exercise, upper respiratory tract infections, household pets, smoking, strong emotions, exposure to in house wood or charcoal burning, weather, use of corticosteroids, beta-blockers and non-steroidal anti-inflammatory drugs. Univariate and multivariate statistical analysis was done using SPSS version 16 to identify independent risk factors for exacerbations. RESULTS Lack of corticosteroid use (OR = 22.109; 95% Confidence interval 6.952 to 70.315; p < 0.001) and presence of upper respiratory tract infections (OR 4.516; CI 1.258-16.213; p = 0.018) were significantly associated with exacerbations. CONCLUSION Lack of corticosteroid use and upper respiratory tract infections are associated with exacerbations in asthma patients presenting to the Emergency unit of Mulago Hospital.
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Affiliation(s)
- Richard E Sanya
- Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital
| | - Bruce J Kirenga
- Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital
| | - William Worodria
- Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital
| | - Martin Okot-Nwang
- Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital
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45
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Cai J, Zhao A, Zhao J, Chen R, Wang W, Ha S, Xu X, Kan H. Acute effects of air pollution on asthma hospitalization in Shanghai, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2014; 191:139-44. [PMID: 24836410 DOI: 10.1016/j.envpol.2014.04.028] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Revised: 04/22/2014] [Accepted: 04/24/2014] [Indexed: 05/24/2023]
Abstract
Air pollution has been accepted as an important contributor to asthma development and exacerbation. However, the evidence is limited in China. In this study, we investigated the acute effect of air pollution on asthma hospitalization in Shanghai, China. We applied over-dispersed generalized additive model adjusted for weather conditions, day of the week, long-term and seasonal trends. An interquartile range increase in the moving average concentrations of PM10, SO2, NO2 and BC on the concurrent day and previous day corresponded to 1.82%, 6.41%, 8.26% and 6.62% increase of asthmatic hospitalization, respectively. The effects of SO2 and NO2 were robust after adjustment for PM10. The associations appeared to be more evident in the cool season than in the warm season. Our results contribute to the limited data in the scientific literature on acute effects of air pollution on asthma in high exposure settings, which are typical in developing countries.
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Affiliation(s)
- Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Ang Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Jinzhuo Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment and Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, 130 Dong-An Road, Shanghai 200433, China
| | - Weibing Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China
| | - Sandie Ha
- Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, FL, USA
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, China; Research Institute for the Changing Global Environment and Fudan Tyndall Centre, Fudan University, Shanghai, China; Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention (LAP(3)), Fudan University, 130 Dong-An Road, Shanghai 200433, China.
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46
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Zhang Y, Peng L, Kan H, Xu J, Chen R, Liu Y, Wang W. Effects of meteorological factors on daily hospital admissions for asthma in adults: a time-series analysis. PLoS One 2014; 9:e102475. [PMID: 25019158 PMCID: PMC4097056 DOI: 10.1371/journal.pone.0102475] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 06/19/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There is limited evidence for the impacts of meteorological changes on asthma hospital admissions in adults in Shanghai, China. OBJECTIVES To quantitatively evaluate the short-term effects of daily mean temperature on asthma hospital admissions. METHODS Daily hospital admissions for asthma and daily mean temperatures between January 2005 and December 2012 were analyzed. After controlling for secular and seasonal trends, weather, air pollution and other confounding factors, a Poisson generalized additive model (GAM) combined with a distributed lag non-linear model were used to explore the associations between temperature and hospital admissions for asthma. RESULTS During the study periods, there were 15,678 hospital admissions for asthma by residents of Shanghai, an average 5.6 per day. Pearson correlation analysis found a significant negative correlation (r = -0.174, P<0.001) between asthma hospitalizations and daily mean temperature (DMT). The DMT effect on asthma increased below the median DMT, with lower temperatures associated with a higher risk of hospital admission for asthma. Generally, the cold effect appeared to be relatively acute, with duration lasting several weeks, while the hot effect was short-term. The relative risk of asthma hospital admissions associated with cold temperature (the 25th percentile of temperature relative to the median temperature) was 1.20 (95% confidence interval [CI], 1.01∼1.41) at lag0-14. However, warmer temperatures were not associated with asthma hospital admissions. CONCLUSIONS Cold temperatures may trigger asthmatic attacks. Effective strategies are needed to protect populations at risk from the effects of cold.
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Affiliation(s)
- Yue Zhang
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Li Peng
- Shanghai Center for Urban Environmental Meteorology, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Haidong Kan
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China
| | - Jianming Xu
- Shanghai Center for Urban Environmental Meteorology, Shanghai, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai, China
| | - Renjie Chen
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Yuan Liu
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China
| | - Weibing Wang
- Department of Epidemiology, School of Public Health, and Key Laboratory of Public Health Safety (Ministry of Education), Fudan University, Shanghai, China; Fudan Tyndall Centre, Fudan University, Shanghai, China
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Ng CFS, Ueda K, Ono M, Nitta H, Takami A. Characterizing the effect of summer temperature on heatstroke-related emergency ambulance dispatches in the Kanto area of Japan. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2014; 58:941-8. [PMID: 23700200 DOI: 10.1007/s00484-013-0677-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Revised: 04/26/2013] [Accepted: 04/26/2013] [Indexed: 05/13/2023]
Abstract
Despite rising concern on the impact of heat on human health, the risk of high summer temperature on heatstroke-related emergency dispatches is not well understood in Japan. A time-series study was conducted to examine the association between apparent temperature and daily heatstroke-related ambulance dispatches (HSAD) within the Kanto area of Japan. A total of 12,907 HSAD occurring from 2000 to 2009 in five major cities-Saitama, Chiba, Tokyo, Kawasaki, and Yokohama-were analyzed. Generalized additive models and zero-inflated Poisson regressions were used to estimate the effects of daily maximum three-hour apparent temperature (AT) on dispatch frequency from May to September, with adjustment for seasonality, long-term trend, weekends, and public holidays. Linear and non-linear exposure effects were considered. Effects on days when AT first exceeded its summer median were also investigated. City-specific estimates were combined using random effects meta-analyses. Exposure-response relationship was found to be fairly linear. Significant risk increase began from 21 °C with a combined relative risk (RR) of 1.22 (95% confidence interval, 1.03-1.44), increasing to 1.49 (1.42-1.57) at peak AT. When linear exposure was assumed, combined RR was 1.43 (1.37-1.50) per degree Celsius increment. Overall association was significant the first few times when median AT was initially exceeded in a particular warm season. More than two-thirds of these initial hot days were in June, implying the harmful effect of initial warming as the season changed. Risk increase that began early at the fairly mild perceived temperature implies the need for early precaution.
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Affiliation(s)
- Chris Fook Sheng Ng
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, 305-8506, Japan,
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Mochimasu KD, Miyatake N, Tanaka N, Kinoshita H. Lower air temperature is associated with ambulance transports and death in Takamatsu area, Japan. Environ Health Prev Med 2014; 19:253-7. [PMID: 24615276 DOI: 10.1007/s12199-014-0385-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Accepted: 02/17/2014] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate the linkage among ambulance transports, the number of death and air temperature in Takamatsu area, Japan. METHODS Monthly data of ambulance transports (total and acute disease) and the number of death from 2004 to 2012 were obtained from Fire Department Service in Takamatsu and Takamatsu city official website, Japan. Climate parameters for required period were also obtained from Japan Meteorological Agency. Population data in Takamatsu area were also used to adjust ambulance transports and the number of death. The linkage among ambulance transports, the number of death and climate parameters was evaluated by ecological analysis. RESULTS Total ambulance transports (/a hundred thousand people/day) and ambulance transports due to acute disease (/a hundred thousand people/day) were 12.3 ± 0.9 and 6.8 ± 0.7, respectively. The number of death (/a hundred thousand people/day) was 2.5 ± 0.4. By quadratic curve, ambulance transports due to acute disease and the number of death were significantly correlated with the parameters of air temperature. However, the number of death was the highest in January and the lowest in August. CONCLUSION Although higher air temperature was only associated with higher ambulance transports, lower air temperature was associated with both higher ambulance transports and the number death in Takamatsu area, Japan.
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Soyiri IN, Reidpath DD, Sarran C. Forecasting asthma-related hospital admissions in London using negative binomial models. Chron Respir Dis 2013; 10:85-94. [PMID: 23620439 DOI: 10.1177/1479972313482847] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Health forecasting can improve health service provision and individual patient outcomes. Environmental factors are known to impact chronic respiratory conditions such as asthma, but little is known about the extent to which these factors can be used for forecasting. Using weather, air quality and hospital asthma admissions, in London (2005-2006), two related negative binomial models were developed and compared with a naive seasonal model. In the first approach, predictive forecasting models were fitted with 7-day averages of each potential predictor, and then a subsequent multivariable model is constructed. In the second strategy, an exhaustive search of the best fitting models between possible combinations of lags (0-14 days) of all the environmental effects on asthma admission was conducted. Three models were considered: a base model (seasonal effects), contrasted with a 7-day average model and a selected lags model (weather and air quality effects). Season is the best predictor of asthma admissions. The 7-day average and seasonal models were trivial to implement. The selected lags model was computationally intensive, but of no real value over much more easily implemented models. Seasonal factors can predict daily hospital asthma admissions in London, and there is a little evidence that additional weather and air quality information would add to forecast accuracy.
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Park M, Luo S, Kwon J, Stock TH, Delclos G, Kim H, Yun-Chul H. Effects of Air Pollution on Asthma Hospitalization Rates in Different Age Groups in Metropolitan Cities of Korea. AIR QUALITY, ATMOSPHERE, & HEALTH 2013; 6:10.1007/s11869-013-0195-x. [PMID: 24223075 PMCID: PMC3821782 DOI: 10.1007/s11869-013-0195-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Many studies have shown associations between air pollution and asthma admissions in Korea, but have not reported whether these effects differ by age classification. The purpose of this study was to determine whether air pollution effects on asthmatic hospital admissions are different by three age groups (years): children (less than 15), adults (15-64; reference group), and the elderly (over 65). Daily time-series data from seven metropolitan cities in South Korea were analyzed in two stages. In the first stage, relative asthma morbidity rates associated with air pollution were estimated for each city and age group, using semi-parametric log-linear regression. In the second stage, estimates from all seven cities were combined by age group using Bayesian hierarchical modeling. The effects of exposure to particulate matter <10 micrometers in aerodynamic diameter (PM10), carbon monoxide (CO) and nitrogen dioxide (NO2) varied significantly by age groups. Using adults as the referent, the relative rate (RR) of asthma admissions with 10μg/m3 increase of PM10 is 1.5% (95%CI: 0.1-2.8%) lower for children, and 1.3% (95% CI: 0.7-1.9%) higher for the elderly; RR with 1ppm increase of CO is 1.9% (95% CI: 0.3-3.8%) lower for children; RR with 1ppb increase of NO2(1ppb) is 0.5% (95% CI: 0.3-0.7%) higher for the elderly. No significant age group difference in relative rate was found for ozone or sulfur dioxide.
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